摘要
目的 探讨血管紧张素Ⅱ受体拮抗剂洛沙坦对同种异体肾移植患者移植肾的保护作用。方法 2 0 0 0年 1月至 2 0 0 1年 3月期间 ,对肾移植术后时间达 1年、移植肾功能正常、尿TGF β1相对浓度≥ 2 5 0 .0pg/mg .Cr的 2 1例患者 (A组 )连续使用洛沙坦 (5 0mg/d) 1年以上 ,与同期相同条件但未服用洛沙坦的 2 3例患者 (B组 )作对比 ,3年后比较两组患者血和尿TGF β1相对浓度、肌酐清除率 (Ccr)减少量和肾功能不全的病例数有无差异 ;观察服用洛沙坦的不良反应。结果 在 3年随访期内 ,A组Ccr减少量为 4.8± 4.6ml/min ,有 2例 (9.5 % )患者肾功能不全 ,均明显低于B组 (P <0 .0 1、0 .0 5 ) ,后者分别为 13 .7± 9.5ml/min和 9例 ;3年后A、B两组尿TGF β1浓度分别为 3 15 .5± 44 .6、5 0 7.7± 5 3 .1(pg/mg .Cr) ,A组明显低于B组 (P <0 .0 1) ;两组血TGF β1浓度无明显差异 (P >0 .0 5 ) ;A组服用洛沙坦后无不良反应发生 ;A、B两组中肾功能不全者 ,穿刺活检证实均为慢性移植物肾病。结论 洛沙坦对同种异体肾移植患者移植肾具有保护作用 ,其作用机制可能与降低移植肾内TGF β1的分泌有关。
Objective To observe losartan,a specific angi otensinⅡ receptor antagonist,has a role in protecting allograft in renal transpl ant recipients.Methods From January 1,2000 to March 31 twenty-one renal transplant recipients whose urine TGF-β 1 concentr ation were higher than 250.0 pg/mg.Cr wi th normal renal function began angiotens in Ⅱ receptor antagonist (losartan )ther apy one year after surgery were studied as group A.Each patient in group A take 50mg losartan every day for at least one year.Twenty-three recipients who never received angiotensin Ⅱ receptor antagoni st were studied as group B in the same f ashion.Side-effects for takeing losartan were investigated in all patients in gr oup A.3 years after initiation of losart an,renal function and blood and urine TG F-β 1 concentration were compared betwee n the two groups.Results Three years later,Cc r had been lost for 4.8±4.6(ml/min)and t here were 2 recepients with chronic allo graft nephropathy (CAN) in group A,but g roup B had lost 13.7±9.5(ml/min)in Ccr a nd showed 9 recepients with CAN.There we re significantly more loss of renal func tion and more number of CAN cases in gro up B than group A.Urine TGF-β 1 concentr ations were 315.5±44.6 and 507.7±53.1(pg /mg.Cr)in group A and B respectively 3 y ears after initiation of losartan.It was significantly higher in group A than gro up B.The values of blood TGF-β 1 concent ration did not reveal any significant di fference between the two groups.No side- effects were noted in all patients who h ad taken losartan.Conclusion Losartan can prev ent chronic allograft nephropathy(CAN) i n renal transplant recipients through re ducing TGF-β 1 secretion in the kidney.
出处
《四川医学》
CAS
2005年第1期25-28,共4页
Sichuan Medical Journal
关键词
肾移植
肾病
转移生长因子
洛沙坦
kidney transplan tation
nephropathy
TGF-β 1
losartan
