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      标题:罗伐他汀对老年高通量血液透析患者血脂和颈动脉硬化的影响
      作者:夏艳芝,曾文    (华润武钢总医院肾内科,湖北 武汉 430000)
      卷次: 2018年29卷1期
      【摘要】 目的 探讨罗伐他汀对老年高通量血液透析患者血脂及颈动脉硬化的保护作用。方法 选取2015年6月至2016年12月在华润武钢总医院接受维持性血液透析治疗的60岁以上的患者共80例,按随机数表法分为对照组和罗伐他汀组,每组40例。对照组采用高通量血液透析治疗,每周3次,每次4 h;罗伐他汀组在对照组治疗的基础上加用罗伐他汀治疗,20 mg/d,1次/d,共治疗6个月,比较两组患者治疗前及治疗6个月后的血脂、心肌功能及颈动脉硬化相关指标。结果 两组患者在年龄、性别、体质量、体质量指数(BMI)、透析时间、血肌酐( Scr)、血尿素氮(BUN)及透析充分性方面比较,差异均无统计学意义(P>0.05);治疗前,两组患者的血脂水平、心肌功能指标、颈动脉内膜中层厚度(IMT)、斑块厚度、超敏C反应蛋白(hs-CRP)、白介素-6 (IL-6)及肿瘤坏死因子-α (TNF-α)比较差异均无统计学意义(P>0.05);治疗后,罗伐他汀组患者的总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、脉搏波传导速率(baPWV)、超敏肌钙蛋白( hs-cTn)、IMT、斑块厚度值、hs-CRP、IL-6及TNF-α均低于对照组,差异均有统计学意义(P<0.05);治疗期间,对照组患者的心脑血管疾病发生率为7.5%,低于罗伐他汀组的5.0%,差异有统计学意义(P<0.05)。结论 罗伐他汀治疗老年血液透析患者可显著降低血脂及胆固醇的水平,减慢患者bapWV,降低 IMT及斑块厚度,控制炎症和心血管事件的发生。
      【关键词】 罗伐他汀;血液透析;血脂;动脉硬化;炎症
      【中图分类号】 R459.5 【文献标识码】 A 【文章编号】 1003—6350(2018)01—0014—04
Effect of rosuvastatin on blood lipids and carotid atherosclerosis in elderly patients with high flux hemodialysis.XIA Yan-zhi, ZENG Wen. Department of Nephrology, China Resource and WISCO General Hospital, Wuhan 430000, Hubei,CHINA
      【Abstract】 Objective To observe the protective effect of of rosuvastatin on blood lipids and carotid atheroscle-rosis in elderly patients with high flux hemodialysis. Methods A total of 80 elderly patients older than 60 years, whoadmitted to China Resource and WISCO General Hospital and was treated with hemodialysis from June 2015 to Decem-ber 2016, were selected and divided into the control group and the rosuvastatin group according to random number tablemethod, with 40 patients in each group. The control group was treated with conventional high flux hemodialysis, and therosuvastatin group was treated with conventional high flux hemodialysis combined with the usage of rosuvastatin (20 mg/d,one time per day for six months). The related indicators including blood lipids, myocardial function and carotid athero-sclerosis before and six months after the treatment were compared between the two groups. Results There was no sig-nificant difference between the two groups in terms of age, gender, weight, body mass index (BMI), dialysis time, serumcreatinine (Scr), blood urea nitrogen (BUN) and single-pool Kt/V (spKt/V) (P>0.05). Before the treatment, there was nosignificant difference between the two groups in terms of lipids, myocardial function index, intima-media thickness(IMT), plaque thickness, high sensitive CRP (hs-CRP), interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α) (P>0.05). After the treatment, the total cholesterol (TC), low-density lipoproteins (LDL-C), triglycerides (TG), brachial-an-kle pulse wave velocity (baPWV), high-sensitivity cardiac troponin (hs-cTn), IMT, plaque thickness, hs-CRP, IL-6, andTNF-α in the rosuvastatin group were significantly lower than those in the control group (P<0.05). The incidence of car-diovascular and cerebrovascular diseases was 7.5% in the control group, which was significantly higher than 5.0% in therosuvastatin group (P<0.05). Conclusion Rosuvastatin can significantly reduce blood lipids and carotid atherosclerosisin elderly patients with hemodialysis, slow down the baPWV, reduce the carotid artery intima-media thickness andplaque thickness, control the inflammation, and reduce the incidence of cardiovascular events.
      【Key words】 Rosuvastatin; Hemodialysis; Blood lipid; Arteriosclerosis; Inflammation·论 著·doi:10.3969/j.issn.1003-6350.2018.01.005

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