目的 探讨参麦注射液对慢性肾功能衰竭维持性血液透析患者微炎症状态、相关炎症因子和左心室肥厚的影响.方法 将维持性血液透析的慢性肾功能衰竭患者60例,随机分为观察组和对照组,各30例.在常规治疗基础上,对照组给予阿托伐他汀钙,观察组给予阿托伐他汀钙和参麦.两组患者于治疗前和治疗后12周检测超敏C-反应蛋白(hs-CRP)、白介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平,以及心脏彩超检查.结果 治疗12周后,两组患者血清hsCRP、IL-6、TNF-α、TG、TC、LDL-C的水平均有所下降,HDL-C升高,观察组改善更显著(P<0 05);观察组LVM、LVMI和IVST降低,与对照组比较,差异有统计学意义(P<0 05).结论 阿托伐他汀钙联合参麦可以改善肾功能衰竭维持性血液透析患者微炎症状态和脂质代谢,逆转左心室肥厚.%Objective To explore the effect of atorvastatin and Shenmai on status of micro - inflammation, cytokines and left ventricular hypertroph in hemodialysis patients with chronic renal failure. Methods 60 cases patients undergoing maintenance hemodialysis were randomly divided into the intervention group (30 cases) and the control group (30 cases); the patients in control group was treated with atorvastatin in addition to a routine therapy, salbutamol sulphate, the patients in intervention group were treated with atorvastatin and Shenmai in addition to a routine therapy, continuous treatment for 12 weeks. The levels of high sensitivity C -reactive protein ( hs - CRP), interlukin - 6 ( IL - 6), tumor necrosis factor alpha ( TNF - α) and serum lipid were determined, and echocardiographic studies were performed in all patients before and after treatment. Results 12 weeks after treatment, the levels of serum hs - CRP, IL - 6,TNF - α, TG,TC and LDL in the intervention group were significantly lower than those before treatment and in the control group(P ＜ 0. 05 ), while serum HDL was significantly higher than those before treatment and in the control group( P ＜0. 05); the levels of LVM, LVMI, IVST in intervention group were lower significantly than those in control group ( P ＜ 0. 05 ).Conclusion Atorvastatin and Shenmai can significantly improve serum lipid metabolism, decrease the micro - inflammation and reversal of LVH in hemodialysis patients with chronic renal failure, and hence is worthy of being recommended in clinical practice.
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