摘要
目的观察银杏叶胶囊对终末期肾病维持性血液透析(MHD)患者脂代谢紊乱、血管内皮功能、凝血功能及主要心脑血管不良事件(MACCE)的影响。方法将160例终末期肾病拟接受MHD治疗的患者随机分为观察组80例和对照组80例,对照组给予常规血液透析治疗(2~3次/周),观察组在对照组治疗基础上给予银杏叶胶囊口服(2粒/次,3次/d),疗程12个月。观察2组治疗前后一般临床情况(肾功能、血脂、电解质代谢情况)、血管内皮功能、凝血功能变化情况,记录期间MACCE发生情况。结果 2组治疗后血肌酐(SCr)、血尿素氮(BUN)、血磷、血钙水平均明显降低(P均<0.05),但2组间比较差异无统计学意义(P均>0.05);2组治疗后三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平均明显升高(P均<0.05),但观察组上述指标水平均低于对照组(P均<0.05);2组治疗后部分凝血酶时间(APTT)、D-二聚体、纤维蛋白原(FIB)水平和血清内皮素-1(ET-1)、血管性假血友病因子(vWF)水平均明显升高(P均<0.05),而一氧化氮(NO)明显降低(P均<0.05),但观察组上述指标升高或降低程度均低于对照组(P均<0.05);观察组总的MACCE发生率显著低于对照组(P<0.05);Logistic回归分析显示银杏叶胶囊治疗与MACCE发生呈负相关,是其发生的保护因素[OR=0.766,95%CI(0.448,0.842),P<0.05]。结论在终末期肾病患者接受MHD治疗过程中,采用银杏叶胶囊干预能够抑制机体内血脂紊乱和高凝状态,保护血管内皮功能,并降低MACCE的发生率,是一种有效的保护性干预措施。
Objective It is to observe the effect of ginkgo capsule on lipid metabolism disorder, vascular endothelial function, coagulation function and major cardiovascular adverse events in patients with end-stage renal disease treated with maintenance hemodialysis （MHD）. Methods 160 patients with end-stage renal disease treated with MHD were randomly divided into observation group （n =80） treated with MHD ＋ ginkgo capsule and control group （n =80） treated with MHD, both treatment courses were 8 weeks. The changes of general clinical situation （renal function, blood lipid, electrolyte metabolism） , endothelial function and coagulation function of the two groups before and after treatment were observed, the occurrence of MACCE was recorded. Results After treatment, the levels of SCr, BUN, P, Ca were decreased significantly, but no significant difference was found between the two groups; the levels of serum TG, TC, LDL-C, D-D, FIB, ET-1, vWF and APTT were increased while that of NO was decreased obviously in both groups, but the decrease or increase was more significant in observation group. The total occurrence rate of MACCE in the observation group was significantly lower than that in the control group （ P 〈 0.05 ）. Logistic regression analysis showed that the treatment of ginkgo capsule was negatively correlated with the occurrence of MACCE, which was the protective factor [ （ OR = 0. 766,95% CI（0. 448,0. 842） ,P 〈 0.05 ]. Conclusion Ginkgo capsule is a protective intervention which could inhibit the blood lipid disorder and high coagulation state in the body and protect endothelial function, and reduce the incidence of MACCE in the patients with end - stage renal disease treated with MHD.
作者
付群英
雷蕾
王颖
解立怡
FU Qunying LEI Lei WANG Ying XIE Liyi(Shaanxi Provincial Friendship Hospital, Xi＇ an 710068, Shaanxi, China)
出处
《现代中西医结合杂志》
CAS
2017年第29期3215-3218,共4页
Modern Journal of Integrated Traditional Chinese and Western Medicine
关键词
终末期肾病
维持性血液透析
银杏叶胶囊
凝血功能
血管内皮细胞
心脑血管不良事件
end-stage renal disease
maintenance hemodialysis
ginkgo capsule
coagulation function
vascular endothelial cells
cardiac cerebrovascular adverse event
