螺内酯对腹膜透析患者心脏及残余肾功能的影响

王超超; 林永强; 赵润英; 陈琪

doi:10.16766/j.cnki.issn.1674-4152.000358

螺内酯对腹膜透析患者心脏及残余肾功能的影响

doi: 10.16766/j.cnki.issn.1674-4152.000358

1. 温州市中西医结合医院肾内科, 浙江温州 325000;
2. 湖州市第一人民医院肾内科, 浙江湖州 313000

基金项目:

浙江省医药卫生科技计划项目(2015DTA017)；浙江省温州市科学技术局科技计划项目(Y20170308)

详细信息

通讯作者:
林永强,E-mail:147072058@qq.com

中图分类号: R459.5;R692
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- 被引次数: 0
出版历程
- 收稿日期: 2017-10-17
- 网络出版日期: 2022-08-06

Effects of spironolactone on cardiac and residual renal function in patients with peritoneal dialysis

Department of Nephrology, Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的探讨螺内酯对腹膜透析(PD)患者心脏及残余肾功能(RRF)的影响。方法将2015年1月-2016年12月期间在我院规律进行PD的96例终末期肾病(ESRD)患者按随机数表法分为试验组与对照组,每组48例。对照组给予血管紧张素转化酶抑制剂(ACEI)/紧张素受体拮抗剂(ARB)治疗,试验组在对照组基础上另给予螺内酯治疗,对比2组治疗前、治疗6个月、12个月后的心脏相关指标[左心室质量指数(LVMI)、左心室射血分数(LVEF)]、RRF指标[残余尿素清除指数(KT/V)、残肾肌酐清除率(Ccr)]、营养贫血指标、24小时尿量、腹膜超滤量及钙磷代谢指标变化情况。结果治疗6个月、12个月后,2组LVMI明显低于治疗前,且试验组均低于对照组,而2组LVEF明显高于治疗前,且试验组均高于对照组,差异具有统计学意义(P<0.05);对照组在治疗6个月、12个月时的KT/V、Ccr均呈下降趋势,差异有统计学意义(P<0.05),而试验组在治疗6个月、12个月与治疗前KT/V、Ccr差异均无统计学意义(P>0.05);2组治疗6个月、12个月的24小时尿量均逐渐减少(P<0.05),对照组较试验组减少更加显著(P<0.05),治疗6个月后,试验组的24小时尿量显著多于对照组(P<0.05);治疗12个月后,2组血磷、钙磷乘积均低于治疗前,且试验组均低于对照组,而血钙高于治疗前,且试验组高于对照组,差异具有统计学意义(P<0.05)。结论螺内酯可有效改善PD患者的心脏功能,保护患者RRF,有效控制钙磷代谢,且基本不影响患者营养状况与腹膜超滤量。
- 螺内酯 /
- 腹膜透析 /
- 心功能 /
- 残余肾功能
Abstract: Objective To investigate the effect of spironolactone on cardiac and residual renal function (RRF) in patients with peritoneal dialysis (PD). Methods A total of 96 patients with end-stage renal disease (ESRD) who underwent PD in our hospital from January, 2015 to December, 2016 were randomly divided into experimental group and control group (n=48). The control group was treated with angiotensin converting enzyme inhibitor (ACEI)/agonist receptor antagonist (ARB). The experimental group was treated with spironolactone on the basis of the control group. Left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF), RRF index[residual urea clearance index (KT/V), residual renal creatinine clearance (Ccr)], nutritional anemia, 24 h urine output, peritoneal ultrafiltration and calcium and phosphorus metabolism changes were compared. Results After 6 months and 12 months, the LVMI of the two groups was significantly lower than that before treatment, and the experimental group was lower than the control group. The LVEF of the two groups was significantly higher than that before the treatment, and the test group was higher than the control group (P<0.05). After 6 months and 12 months, the levels of KT/V and Ccr in the control group tend to decrease with statistical significance (P<0.05). There was no significant difference in the levels of KT/V and Ccr in the experimental group (P>0.05). After 6 months and 12 months, the urine output within 24 hours gradually decreased (P<0.05), and the control group decreased more significantly than the experimental group. After 6 months of treatment, the urine output within 24 hours of the experimental group was significantly higher than that of the control group (P<0.05). After 12 months of treatment, the products of serum phosphorus and calcium phosphorus of both groups were lower than those before treatment and the experimental group was lower than the control group. The serum phosphorus was higher than that before treatment, and the experimental group was higher than that before treatment, with significant difference(P<0.05). Conclusion Spironolactone can improve the cardiac function of PD patients, protect patients with RRF, effectively control calcium and phosphorus metabolism, and basically does not affect the nutritional status of patients and peritoneal ultrafiltration, thus worthy of further promotion.
- Spironolactone /
- Peritoneal dialysis /
- Cardiac function /
- Residual renal function