CAJ | 학술논문

目的观察血管紧张素转换酶抑制剂/血管紧张素Ⅱ(ACEI/ARBs)类药物对腹膜透析(PD)患者透出液的蛋白含量的影响.方法回顾性分析81例PD患者的透出液蛋白含量,其中37例患者接受ACEI/ARBs治疗(观察组),44例未接受ACEI/ARBs治疗(对照组).采用自身对照和组间对照的方法评估ACEi/ARBs治疗对患者透出液蛋白含量的影响;分层分析残余肾功能、透析龄对ACEI/ARBs类药物疗效的影响.结果 (1)与治疗前比较,观察组患者ACEI/ARBs治疗后的透出液蛋白含量减少,中位差值1.2(0,1.6) g/24 h,与对照组差值比较差异有统计学意义(P＜0.05).(2)eGFR＞2 ml·min-1·(1.73 m2)-1组患者ACEI/ARB治疗后透出液蛋白含量减少,中位差值1.4(1.2,2.3) g/24 h,与对照组比较差异有统计学意义(P＜0.001);eGFR＜2 ml· min-1·(1.73 m2)-1组患者透出液蛋白含量差值与对照组比较差异无统计学意义.(3)透析龄＜12月组患者ACEI/ARBs治疗后透出液中蛋白含量较治疗前减少,中位差值1.0(0.8,1.4) g/24 h,与对照组相比差异有统计学意义(P＜0.05);透析龄12～ 24个月和＞24个月组患者透出液蛋白含量差值与对照组相比差异均无统计学意义(P＞0.05).结论 ACEI/ARBs能减少患者腹膜透出液中的蛋白丢失,在残余肾功能较好和透析龄较短的患者中效果更明显.
목적 관찰혈관긴장소전환매억제제/혈관긴장소Ⅱ(ACEI/ARBs)류약물대복막투석(PD)환자투출액적단백함량적영향.방법 회고성분석81례PD환자적투출액단백함량,기중37례환자접수ACEI/ARBs치료(관찰조),44례미접수ACEI/ARBs치료(대조조).채용자신대조화조간대조적방법평고ACEi/ARBs치료대환자투출액단백함량적영향;분층분석잔여신공능、투석령대ACEI/ARBs류약물료효적영향.결과 (1)여치료전비교,관찰조환자ACEI/ARBs치료후적투출액단백함량감소,중위차치1.2(0,1.6) g/24 h,여대조조차치비교차이유통계학의의(P＜0.05).(2)eGFR＞2 ml·min-1·(1.73 m2)-1조환자ACEI/ARB치료후투출액단백함량감소,중위차치1.4(1.2,2.3) g/24 h,여대조조비교차이유통계학의의(P＜0.001);eGFR＜2 ml· min-1·(1.73 m2)-1조환자투출액단백함량차치여대조조비교차이무통계학의의.(3)투석령＜12월조환자ACEI/ARBs치료후투출액중단백함량교치료전감소,중위차치1.0(0.8,1.4) g/24 h,여대조조상비차이유통계학의의(P＜0.05);투석령12～ 24개월화＞24개월조환자투출액단백함량차치여대조조상비차이균무통계학의의(P＞0.05).결론 ACEI/ARBs능감소환자복막투출액중적단백주실,재잔여신공능교호화투석령교단적환자중효과경명현.
Objective To observe the effect of ACEI/ARBs on peritoneal protein loss in peritoneal dialysis patients.Methods Total of 81 peritoneal dialysis patients were included in the study.Thirty-seven cases were treated with ACEI/ARBs(ACEI/ARBs group),forty-four cases did not receive any ACEI/ARBs (Control group).After 6 mouths,the effect of ACEI/ARBs on peritoneal protein loss was evaluated,and the effects of residual renal function and dialysis age on the peritoneal protein loss were statistically analyzed.Results (1) The peritoneal protein loss was reduced in ACEI/ARBs group,the difference was 1.2(0,1.6) g/24 h,while in the control group,the protein loss had no statistically significant change,the difference between the two group was statistically significant (P ＜0.05).(2) When the patients' eGFR ＞ 2 ml · min-1 · (1.73 m2)-1,the difference of the protein loss in ACEI/ARBs group was 1.4(1.2,2.3) g/24 h,the difference between the two group was statistically significant(P ＜ 0.01); when patients' eGFR ＜ 2 ml· min-1· (1.73 m2)-1,the differences of the protein loss between the two groups had no significant difference (P＞ 0.05).(3) When the dialysis ages ＜ 12months,the difference of the protein loss was 1.0(0.8,1.4) g/24 h in ACEI/ARBs group,the differences between the two groups was statistically significant (P ＜ 0.05); when the dialysis ages was from 12 months to 24 months or more than 24 months,The differences of the protein loss between the two groups and control group were both not statistically significant (P ＞ 0.05).Conclusion ACEI/ARBs can reduce peritoneal protein loss in PD patient,the effect was better when patients' residual renal function was better or dialysis age was shorter.