CAJ | 학술논문

目的：观察贝那普利治疗肾移植术后红细胞增多症（PTE ）的疗效及不良反应。方法选择2012年6月至2013年6月在解放军第309医院泌尿外科行首次肾移植术，术后继发 PTE 的22例患者为研究对象，根据有否高血压分为高血压组（14例）和正常血压组（8例）。高血压组给予贝那普利，起始剂量为10 mg／d，以后视病情变化最大剂量可增至40 mg／d；正常血压组给予贝那普利5 mg／d，血红蛋白及红细胞压积恢复正常后予以维持剂量2.5 mg／d。随访6个月比较两组患者服药后治疗效果和随访期间的不良反应。结果治疗6个月后，高血压组显效12例、有效1例、进步1例；正常血压组显效6例、有效1例、无效1例。两组疗效比较，差异无统计学意义（P ＞0.05）。治疗过程中高血压组患者血压明显下降（P ＜0.05），正常血压组患者血压未见明显变化。治疗前后两组患者的红细胞、中性粒细胞、血小板、血清肌酐、尿酸、估计肾小球滤过率等指标未见明显异常。高血压组中1例患者治疗期间出现刺激性咳嗽，停药后恢复正常。结论肾移植术后 PTE 患者服用贝那普利治疗是安全有效的。应根据患者的血压从小剂量开始给药，治疗过程中监测血压、血常规和肾功能，根据血压调整药物剂量。
목적：관찰패나보리치료신이식술후홍세포증다증（PTE ）적료효급불량반응。방법선택2012년6월지2013년6월재해방군제309의원비뇨외과행수차신이식술，술후계발 PTE 적22례환자위연구대상，근거유부고혈압분위고혈압조（14례）화정상혈압조（8례）。고혈압조급여패나보리，기시제량위10 mg／d，이후시병정변화최대제량가증지40 mg／d；정상혈압조급여패나보리5 mg／d，혈홍단백급홍세포압적회복정상후여이유지제량2.5 mg／d。수방6개월비교량조환자복약후치료효과화수방기간적불량반응。결과치료6개월후，고혈압조현효12례、유효1례、진보1례；정상혈압조현효6례、유효1례、무효1례。량조료효비교，차이무통계학의의（P ＞0.05）。치료과정중고혈압조환자혈압명현하강（P ＜0.05），정상혈압조환자혈압미견명현변화。치료전후량조환자적홍세포、중성립세포、혈소판、혈청기항、뇨산、고계신소구려과솔등지표미견명현이상。고혈압조중1례환자치료기간출현자격성해수，정약후회복정상。결론신이식술후 PTE 환자복용패나보리치료시안전유효적。응근거환자적혈압종소제량개시급약，치료과정중감측혈압、혈상규화신공능，근거혈압조정약물제량。
Objective To observe the curative effect and adverse reaction of benazepril on polycythemia (PTE ) after renal transplantation. Methods Twenty-two patients undergoing kidney transplantation for the first time at the Department of Urinary Surgery of the 309 th Hospital of People's Liberation Army and developed PTE after renal transplantation from June 2012 to June 2013 were enrolled as the object of study.The patients were divided into the hypertension group (n =14)and the normal blood pressure group (n =8)according to whether the patients were with hypertension or not.The hypertension group was given benazepril with an initial dose of 10 mg/d and increased to the maximum dose of 40 mg/d according to the changes of patients’conditions.The normal blood pressure group was given benazepril with an initial dose of 5 mg/d and with the maintenance dose of 2.5 mg/d after hemoglobin and hematokrit returning to normal.The patients in two groups were followed up for 6 months.The curative effect and adverse reactions during the follow-up were compared between the two groups.Results After 6 months of treatment,12 patients had marked effect,1 had effect and 1 was improved in the hypertension group.Six patients had marked effect, 1 had effect and 1 had no effect in the normal blood pressure group.The difference of efficacy had no statistical significance between the two groups (P >0.05).During the treatment,the blood pressure of the hypertension group dropped significantly (P <0.05 ),while that of the normal blood pressure group had no significant change.Red blood cells,neutrophils,platelets,serum creatinine,uric acid and estimated glomerular filtration rate of the two groups had no obvious abnormality before and after treatment.One patient in the hypertension group developed irritable cough during the treatment and recovered after withdrawal.Conclusions It is safe and effective to take benazepril for patients with PTE after renal transplantation.It is recommended to start with small dose and the dose shall be adjusted according to blood pressure.The blood pressure,blood routine and renal function shall be monitored during the treatment.