CAJ | 학술논문

目的：测定慢性肾脏病3~4期患者肾皮质血流灌注水平,并观察普罗布考对肾皮质血流灌注及肾功能的影响。方法选取慢性肾脏病3~4期患者20例,随机分为治疗组10例及观察组10例,同时选取10名健康人作为对照组,采用超声动态评估组织灌注( DTPM)技术评价3组患者肾皮质感兴趣区平均灌注强度( Imix )、平均血流速度( Vmix )、组织阻力指数( TRI)。观察组继续常规治疗,治疗组在常规治疗的基础上给予普罗布考片,每次500 mg,bid,疗程均6个月,观察两组患者治疗后肾皮质血流变化,同时检测治疗前后血尿素氮( BUN)、血清肌酐( SCr)、血清前清蛋白( PA)、血清清蛋白(ALB)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、高敏 C反应蛋白(hs_CRP)、氧化低密度脂蛋白( ox_LDL)变化,比较其疗效。结果治疗组及观察组治疗前Imix、Vmix明显低于对照组,TRI明显高于对照组(P<0.01)。治疗6个月后治疗组与治疗前及观察组比较,Imix、Vmix增加,TRI降低,差异有统计学意义(P<0.01)；观察组治疗后与治疗前比较,Imix、Vmix下降,TRI升高,差异有统计学意义(P<0.05)。治疗组与治疗前及观察组比较,BUN、SCr、TC、TG、LDL、hs_CRP、ox_LDL降低,PA、ALB、HDL升高,差异有统计学意义(P<0.05或P<0.01)。结论慢性肾脏病3~4期患者肾皮质血流灌注明显低于健康人,普罗布考能明显改善慢性肾脏病患者肾皮质血流灌注水平,保护肾功能,同时改善微炎症状态、营养状况及脂代谢紊乱。
목적：측정만성신장병3~4기환자신피질혈류관주수평,병관찰보라포고대신피질혈류관주급신공능적영향。방법선취만성신장병3~4기환자20례,수궤분위치료조10례급관찰조10례,동시선취10명건강인작위대조조,채용초성동태평고조직관주( DTPM)기술평개3조환자신피질감흥취구평균관주강도( Imix )、평균혈류속도( Vmix )、조직조력지수( TRI)。관찰조계속상규치료,치료조재상규치료적기출상급여보라포고편,매차500 mg,bid,료정균6개월,관찰량조환자치료후신피질혈류변화,동시검측치료전후혈뇨소담( BUN)、혈청기항( SCr)、혈청전청단백( PA)、혈청청단백(ALB)、총담고순(TC)、삼선감유(TG)、저밀도지단백(LDL)、고밀도지단백(HDL)、고민 C반응단백(hs_CRP)、양화저밀도지단백( ox_LDL)변화,비교기료효。결과치료조급관찰조치료전Imix、Vmix명현저우대조조,TRI명현고우대조조(P<0.01)。치료6개월후치료조여치료전급관찰조비교,Imix、Vmix증가,TRI강저,차이유통계학의의(P<0.01)；관찰조치료후여치료전비교,Imix、Vmix하강,TRI승고,차이유통계학의의(P<0.05)。치료조여치료전급관찰조비교,BUN、SCr、TC、TG、LDL、hs_CRP、ox_LDL강저,PA、ALB、HDL승고,차이유통계학의의(P<0.05혹P<0.01)。결론만성신장병3~4기환자신피질혈류관주명현저우건강인,보라포고능명현개선만성신장병환자신피질혈류관주수평,보호신공능,동시개선미염증상태、영양상황급지대사문란。
Objective To measure the renal cortex blood flow leVel in Patients with stage 3-4 chronic kidney disease, and to obserVe the effect of Probucol on renal cortex blood flow and renal function. Methods Twenty Patients with stage 3-4 chronic kidney disease in our hosPital were randomly diVided into treatment grouP ( 10 Patients ) and obserVation grouP ( 10 Patients). Ten healthy subjects were chosen as the control grouP. Dynamic sonograPhic tissue Perfusion measurement (DTPM) was used to eValuate the mean flow intensity (Imix),mean flow Velocity (Vmix) and tissue resistance index (TRI) in the three grouPs. Patients in the obserVation grouP were treated with standard theraPy;the treatment grouP was giVen Probucol 500 mg,twice daily in addition to standard theraPy for 6 months. The renal cortex blood flow leVel after treatment was measured in the treatment grouP and obserVation grouP. The serum BUN,SCr,TC,TG,LDL,HDL,hs_CRP,ox_LDL,PA,ALB before and after treatment were measured and comPared between the treatment grouP and obserVation grouP. Results Imix and Vmix were significantly lower,and TRI was significantly higher in the treatment grouP and obserVation grouP than in the control grouP (P<0. 01). After 6 months of treatment,Imix and Vmix in the treatment grouP were significantly increased and TRI significantly decreased as comPared with the baseline and the control grouP (P<0. 01). After treatment,Imix and Vmix were significantly decreased and TRI was significantly increased in the obserVation grouP (P<0. 05). In the treatment grouP,the serum BUN,SCr,TC,TG,LDL,hs_CRP and ox_LDL decreased and PA,ALB and HDL increased after treatment as comPared with the baseline and the obserVation grouP (P<0. 05 or P<0. 01). Conclusion The renal cortex blood flow leVel is significantly lower in Patients with stage 3-4 chronic kidney disease than in the healthy PeoPle. Probucol can imProVe the renal cortex blood flow leVel significantly,Protect the renal function, and imProVe microinflammatory state,nutrition status and dysliPidemia.