山东医药Issue(4)：1-4,4.DOI:10.3969/j.issn.1002-266X.2016.04.001
氯沙坦对血液透析患者大动脉僵硬度的影响及机制
Effect of losartan on aortic stiffness in hemodialysis patients
摘要
Abstract
Objective To investigate the effect of the angiotensin Ⅱ receptor blocker losartan on arterial stiffness in hemodialysis patents and its mechanism. Methods Seventy-two hemodialysis patients were randomly assigned to receive either 50 mg losartan, qd (n=36, losartan group) or 5 mg β-blocker bisoprolol, qd (n=36, bisoprolol group). The home blood pressure ( Home-BP ) , aortic pulse wave velocity ( PWV ) , common carotid artery intima-media thickness (IMT), intima-media cross sectional area (IMCSA), serum oxidized low density lipoprotein (ox-LDL) and homeostasis model assessment index of insulin resistance ( HOMA-IR) were determined before treatment and 12 months after treatment. Results After treatment, no significant difference was found in Home-BP between the two groups (P>0. 05). Compared with that before treatment, PWV was decreased in both groups, and the reduction was more significant in the losartan group than that in the bisoprolol group (all P<0. 05). No change in IMT was observed (P>0. 05), and IMCSA was significant-ly decreased in the losartan group after treatment (P<0. 01). On the contrary, no change was found in IMCSA (P>0. 05), but IMT was significantly increased in the bisoprolol group (P<0. 01). In the losartan group, serum ox-LDL and HOMA-IR were significantly decreased (all P<0. 01), but they had no significant change in the bisoprolol group (all P>0. 05). Conclusions Arterial stiffness was significantly attenuated by treatment with losartan in hemodialysis patients, and the effect might be independent of blood pressure reduction, but related to decreasing oxidative stress, improving insu-lin resistance and reducing artery hypertrophy.关键词
血液透析/大动脉僵硬度/氯沙坦Key words
hemodialysis/arterial stiffness/losartan分类
医药卫生引用本文复制引用
孙芳,刘婧,沈洋,马丽洁,黄静,陈向东,赵素梅,周亦伦..氯沙坦对血液透析患者大动脉僵硬度的影响及机制[J].山东医药,2016,(4):1-4,4.基金项目
北京市卫生人才系统高层次卫生技术人才培养学科骨干资助项目(2014-3-021)。 （2014-3-021）
