替米沙坦改善血液透析患者心功能的疗效观察

目的探讨口服替米沙坦对尿毒症维持性血液透析患者心功能保护作用以及应用安全性。方法选择蚌埠市第三人民医院86例慢性肾功能不全(尿毒症期)合并慢性心力衰竭,心功能Ⅲ～Ⅳ级患者,随机分为对照组(硝苯地平组)与观察组(替米沙坦治疗组),经3个月规律血液透析治疗后,重新评定心功能分级,并使用彩色多普勒心脏超声检查左室结构和功能。结果经3个月降血压及血液透析治疗后,两组收缩压、舒张压、心功能分级与治疗前比较差异具有统计学意义(P<0.01),但组间比较,差异无统计学意义(P>0.05)。与透析前比较,两组左心室舒张末期内径透析治疗3个月后均有明显减少(P<0.05);但对照组室间隔厚度(IVST)、左室后壁舒张末期厚度(LVPwT)和最大血流速度比(E/A)透析前后比较差异无统计学意义(P>0.05),观察组透析3个月后IVST、LVPwT明显降低,E/A值显著升高,与透析前及对照组透析后比较差异均有统计学意义(P<0.05)。结论口服替米沙坦对维持性血液透析患者心功能具有保护作用,且服用安全。

Cardioprotective Effects of Telmisartan in Patients Undergoing Hemodialysis

Objective To investigate the cardiac protection and application security of telmisartan in uremia patients with maintenance hemodialysis.Methods Eighty six cases of chronic renal failure(uremia) combined with chronic heart failure,cardiac function grade Ⅲ-Ⅳ were randomly divided into the control group(nifedipine group) and the treatment group(telmisartan group).After the hemodialysis of 3 months,cardiac function was assessed again,and left ventricular structure and function were examined with color Doppler echocardiography.Results The difference in blood pressure,cardiac function and cardiac function grade was significantly(P<0.01) before and after treatment;but not significantly(P>0.05) between the control group and the treatment group after the controlling blood pressure and hemodialysis of 3 months.Left ventricular end-diastolic diameter was reduced(P<0.05) after 3 months of hemodialysis treatment.The difference in the interventricular septum thickness(IVST),left ventricular end-diastolic posterior wall thickness(LVPwT) and maximum flow velocity ratio(E/A) before and after hemodialysis were not significant(P>0.05) in the control group.The IVST,LVPwT were significantly reduced(P<0.05),E/A was significantly increased(P<0.05) in the treatment group after 3 months of hemodialysis.Conclusion Telmisarta is safe and has a positive protective role in maintaining the heart function of patients with hemodialysis.