CAJ | 학술논문

目的：探讨坎地沙坦酯对尿毒症维持性血液透析患者微炎症状态及心功能的影响。方法将40例维持性血液透析患者随机分为研究组与对照组，研究组口服坎地沙坦酯8 mg/d，1次/d，观察治疗6个月，应用酶联免疫吸附实验（ELISA）法检测受试者血清肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）、IL-18及基质金属蛋白酶（MMP-9）水平变化，彩色多普勒超声诊断仪测定两组患者左心室舒张末期内径（LVDd）、左心室收缩末期内径（LVDs）、左心室后壁厚度（LVPWT）、室间隔厚度（IVST）、左心室质量指数（LVMI）、左心室射血分数（LVEF），并对两组患者炎症因子与心功能各指标进行相关性分析。结果坎地沙坦酯组血清TNF-α、IL-6、IL-18及MMP-9水平较对照组明显降低，差异有统计学意义（P＜0.05），心功能各指标较对照组明显改善，差异有统计学意义（P＜0.05），血清炎症因子与心超指标相关性分析显示TNF-α、IL-6及MMP-9与LVDd、LVDs、LVPWT、IVST、LVMI呈正相关关系（P＜0.05），与LVEF呈负相关关系（P＜0.05）；IL-18与LVDs、LVPWT、IVST、LVMI呈正相关关系（P＜0.05），与LVEF呈负相关关系（P＜0.05）；结论坎地沙坦酯对尿毒症维持性血液透析患者心功能及微炎症状态的改善发挥重要作用。尿毒症患者血清中炎症因子水平与心功能指标变化相关。
목적：탐토감지사탄지대뇨독증유지성혈액투석환자미염증상태급심공능적영향。방법장40례유지성혈액투석환자수궤분위연구조여대조조，연구조구복감지사탄지8 mg/d，1차/d，관찰치료6개월，응용매련면역흡부실험（ELISA）법검측수시자혈청종류배사인자-α（TNF-α）、백개소-6（IL-6）、IL-18급기질금속단백매（MMP-9）수평변화，채색다보륵초성진단의측정량조환자좌심실서장말기내경（LVDd）、좌심실수축말기내경（LVDs）、좌심실후벽후도（LVPWT）、실간격후도（IVST）、좌심실질량지수（LVMI）、좌심실사혈분수（LVEF），병대량조환자염증인자여심공능각지표진행상관성분석。결과감지사탄지조혈청TNF-α、IL-6、IL-18급MMP-9수평교대조조명현강저，차이유통계학의의（P＜0.05），심공능각지표교대조조명현개선，차이유통계학의의（P＜0.05），혈청염증인자여심초지표상관성분석현시TNF-α、IL-6급MMP-9여LVDd、LVDs、LVPWT、IVST、LVMI정정상관관계（P＜0.05），여LVEF정부상관관계（P＜0.05）；IL-18여LVDs、LVPWT、IVST、LVMI정정상관관계（P＜0.05），여LVEF정부상관관계（P＜0.05）；결론감지사탄지대뇨독증유지성혈액투석환자심공능급미염증상태적개선발휘중요작용。뇨독증환자혈청중염증인자수평여심공능지표변화상관。
ObjectiveTo investigate the impact of candesartan cilexetil on micro-inlfammatory state and cardiac function in hemodialysis patients.MethodsThe 40 cases of hemodialysis patients were randomly divided into two groups, the study group oral candesartan cilexetil 8mg / day, 1 time / day, observed 6 months of treatment, detected serum TNF-α, IL -6, IL-18 and MMP-9 levels by ELISA. Doppler ultrasonography was used to determine LVDd, LVDs, LVPWT, IVST, LVMI and LVEF in the two groups of MHD patients. The changes of cardiac structure and function were analyzed in correlation to the changes of serum inlfammation factors.ResultsThe levels of serum TNF-α, IL-6, IL-18 and MMP-9 decreased in Candesartan cilexetil group compared to the control group (P<0.05), indexes of heart function significantly improved compared to the control group (P<0.05). Serum inflammatory factors and echocardiographic indicators of correlation analysis showed that TNF-α, IL-6 and MMP-9 was positively correlated to LVDd, LVDs, LVPWT, IVST, LVMI (P<0.05), and negatively correlated to LVEF (P<0.05); IL-18 was positively correlated to LVDs, LVPWT, IVST, LVMI (P<0.05), and negatively correlated to LVEF (P<0.05). ConclusionCandesartan cilexetil play an important role in improving micro-inlfammation and cardiac function in uremic hemodialysis patients. Levels of serum inlfammatory factors associated with changes of cardiac function in MHD patients.