普罗布考对慢性肾脏病患者肾皮质血流灌注及肾功能的影响

摘要

目的：测定慢性肾脏病3~4期患者肾皮质血流灌注水平,并观察普罗布考对肾皮质血流灌注及肾功能的影响。方法选取慢性肾脏病3~4期患者20例,随机分为治疗组10例及观察组10例,同时选取10名健康人作为对照组,采用超声动态评估组织灌注( DTPM)技术评价3组患者肾皮质感兴趣区平均灌注强度( Imix )、平均血流速度( Vmix )、组织阻力指数( TRI)。观察组继续常规治疗,治疗组在常规治疗的基础上给予普罗布考片,每次500 mg,bid,疗程均6个月,观察两组患者治疗后肾皮质血流变化,同时检测治疗前后血尿素氮( BUN)、血清肌酐( SCr)、血清前清蛋白( PA)、血清清蛋白(ALB)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、高敏 C反应蛋白(hs_CRP)、氧化低密度脂蛋白( ox_LDL)变化,比较其疗效。结果治疗组及观察组治疗前Imix、Vmix明显低于对照组,TRI明显高于对照组(P<0.01)。治疗6个月后治疗组与治疗前及观察组比较,Imix、Vmix增加,TRI降低,差异有统计学意义(P<0.01)；观察组治疗后与治疗前比较,Imix、Vmix下降,TRI升高,差异有统计学意义(P<0.05)。治疗组与治疗前及观察组比较,BUN、SCr、TC、TG、LDL、hs_CRP、ox_LDL降低,PA、ALB、HDL升高,差异有统计学意义(P<0.05或P<0.01)。结论慢性肾脏病3~4期患者肾皮质血流灌注明显低于健康人,普罗布考能明显改善慢性肾脏病患者肾皮质血流灌注水平,保护肾功能,同时改善微炎症状态、营养状况及脂代谢紊乱。%Objective To measure the renal cortex blood flow leVel in Patients with stage 3-4 chronic kidney disease, and to obserVe the effect of Probucol on renal cortex blood flow and renal function. Methods Twenty Patients with stage 3-4 chronic kidney disease in our hosPital were randomly diVided into treatment grouP ( 10 Patients ) and obserVation grouP ( 10 Patients). Ten healthy subjects were chosen as the control grouP. Dynamic sonograPhic tissue Perfusion measurement (DTPM) was used to eValuate the mean flow intensity (Imix),mean flow Velocity (Vmix) and tissue resistance index (TRI) in the three grouPs. Patients in the obserVation grouP were treated with standard theraPy;the treatment grouP was giVen Probucol 500 mg,twice daily in addition to standard theraPy for 6 months. The renal cortex blood flow leVel after treatment was measured in the treatment grouP and obserVation grouP. The serum BUN,SCr,TC,TG,LDL,HDL,hs_CRP,ox_LDL,PA,ALB before and after treatment were measured and comPared between the treatment grouP and obserVation grouP. Results Imix and Vmix were significantly lower,and TRI was significantly higher in the treatment grouP and obserVation grouP than in the control grouP (P<0. 01). After 6 months of treatment,Imix and Vmix in the treatment grouP were significantly increased and TRI significantly decreased as comPared with the baseline and the control grouP (P<0. 01). After treatment,Imix and Vmix were significantly decreased and TRI was significantly increased in the obserVation grouP (P<0. 05). In the treatment grouP,the serum BUN,SCr,TC,TG,LDL,hs_CRP and ox_LDL decreased and PA,ALB and HDL increased after treatment as comPared with the baseline and the obserVation grouP (P<0. 05 or P<0. 01). Conclusion The renal cortex blood flow leVel is significantly lower in Patients with stage 3-4 chronic kidney disease than in the healthy PeoPle. Probucol can imProVe the renal cortex blood flow leVel significantly,Protect the renal function, and imProVe microinflammatory state,nutrition status and dysliPidemia.