貝前列素鈉對腎移植術后穩定期患者腎臟血流及生化指標的影響

徐小君 應漂 康俏玲

[摘要] 目的 探討應用貝前列素鈉對腎移植術后穩定期患者移植后腎功能的臨床效果。 方法 選取2017年7月至2019年1月收治的96例腎移植穩定期患者作為研究對象，按照簡單隨機法分為對照組和治療組，每組各為48例，兩組分別給予常規免疫抑制治療，治療組加用貝前列素鈉20 μg，tid，持續1年，比較兩組血肌酐（SCr），胱抑素C（Cys-C），尿微量白蛋白（MAU），尿蛋白肌酐比值（UREA）變化，通過彩超比較腎臟血流變化。 結果 治療組腎移植術1年后血肌酐、Cys-C、尿MAU、UAER下降，與對照組相比，差異有統計學意義（P<0.05）;在腎臟血液供應方面有改善，差異有統計學意義（P<0.05）。 結論 腎移植術后穩定期長期免疫抑制治療患者加用貝前列素鈉治療可進一步增加腎臟血供，降低尿微量白蛋白，改善腎功能。

[關鍵詞] 貝前列素鈉;腎移植術后穩定期;腎臟血流;腎臟功能

[中圖分類號] R699.2? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）24-0129-04

Effect of beraprost sodium on renal blood flow and biochemical indexes in patients in stable period after renal transplantation

XU Xiaojun? ?YING Piao? ?KANG Qiaoling

Department of Nephrology， Zhejiang Jinhua Guangfu Hospital， Jinhua? ?321000， China

[Abstract] Objective To compare and analyze the clinical effect of beraprost sodium on the renal function improvement in patients in stable period after renal transplantation. Methods Ninety-six patients in stable period after renal transplantation admitted to our hospital from July 2017 to January 2019 were selected. They were divided into the control group and the treatment group using simple random method，with 48 patients in each group. Both groups were given conventional immunosuppressive therapy.The treatment group were given additional 20 μg tid of beraprost sodium for 1 year. The changes of serum creatinine （SCr），cystatin C （Cys-C），urinary microalbumin （MAU） and urinary albumin/creatinine ratio were compared between the two groups. The change of renal blood flow was compared using color Doppler ultrasound. Results The levels of SCr，Cys-C，urinary MAU and UAER in the treatment group were decreased 1 year after renal transplantation compared with the control group，with significant differences （P<0.05）. The blood supply to the kidney was improved，with significant difference （P<0.05）. Conclusion The addition of beraprost sodium can increase renal blood supply，reduce urine microalbumin，and improve renal function in patients treated with long-term immunosuppressive therapy in stable period after renal transplantation.

[Key words] Beraprost sodium; Stable period after renal transplantation; Renal blood flow; Renal function

慢性腎臟病（Chronic kidney disease，CKD）已成為全球關注的公共健康問題，發病率居高不下，隨著人口老齡化、糖尿病、動脈硬化等因素導致CKD患者進入終末期腎病（End-stage renal disease，ESRD）逐步增加。腹膜透析、血液透析、腎移植是ESRD患者常用腎替代選擇。臨床上，腎移植術是ESRD患者優選的替代治療方法，無論是否合并糖尿病，都能顯著提高患者生活質量，延長患者生存時間[1]，并減少醫療費用，為最常見且管理成熟的器官移植手術之一，如何讓移植腎保持長期穩定，是臨床醫生考慮的方向。