ACEI联合钙通道抑制剂对慢性移植物肾病肾纤维化的影响.docVIP

ACEI联合钙通道抑制剂对慢性移植物肾病肾纤维化的影响 　　作者：周结学，刘 东，吴家清，唐 斌，蒙善东，黎 程，郑克立 作者单位：广东省第二人民医院器官移植科，广东广州 510317 　　【摘要】目的 探讨血管紧张素转换酶抑制剂(ACEI)洛汀新和钙通道抑制剂洛活喜对慢性移植物肾病肾纤维化的影响。方法 将26例慢性移植物肾病患者随机分为两组，治疗组14例和对照组12例，两组均调整免疫抑制剂，但治疗组另加服洛汀新10mg/d，洛活喜5mg/d；随访监测患者治疗前和治疗后的临床及生化指标，并于治疗后1年行移植肾穿刺活检。结果 治疗组动脉血压、血肌酐、尿蛋白均较治疗前显著降低(均P0.01)。对照组血肌酐上升速度减慢，但仍上升，其他生化指标变化不明显。移植肾穿刺活检显示治疗组大部分病例肾间质纤维化程度无变化，而对照组大部分病例肾间质纤维化程度有所加重。结论 洛汀新和洛活喜联合使用可减缓移植肾纤维化过程。 　　【关键词】 洛汀新 洛活喜 慢性移植物肾病 肾纤维化 　　Effects of benazepril and amlodipine on renal fibrosis of chronic allograft nephropathy 　　 Zhou Jiexue, Liu Dong, Wu Jiaqing, Tang Bin, Meng Shandong, Li Cheng, Zheng Keli 　　(the Second Peoples Hospital of Guangdong Province, Guangzhou 510317, China)ABSTRACT: Objective To investigate the effects of benazepril and amlodipine on renal fibrosis of chronic allograft nephropathy (CAN). Methods 26 patients with CAN were randomly divided into two groups, control group (n=12) and therapy group (n=14). Immunosuppressive agents were adjusted in both groups, but the patients in the therapy group additionally took benazepril (10mg/d) and amlodipine (5mg/d). Clinical and biochemical parameters were monitored before and after treatment, and kidney biopsies were performed after one year of treatment. Results In the therapy group, the patients clinical and biochemical parameters were improved, including the decrease of Scr, MAP and urine protein (all P0.01). In the control group, the ascending rate of serum creatinine was slowed down, while other biochemical parameters changed insignificantly. Kidney biopsies showed that renal fibrosis didnt chang in most patients in the therapy group, but become more serious in most patients in the control group. Conclusion Benazepril and amlodipine can delay the process of renal fibrosis. 　　KEY WORDS: banalapril; amlodipine; chronic allograft nephropathy; renal fibrosis 　　慢性移植物肾病(chronic allograft nephropathy, CAN)是远期移植肾失败的主要原因之一。CAN主要以肾间质纤维化、肾小管萎缩和进行性动脉血管纤维性内膜增厚等为特点。作者于2005年3月至