贝前列素钠对肾移植术后稳定期患者肾脏血流及生化指标的影响

徐小君 应漂 康俏玲

[摘要] 目的 探讨应用贝前列素钠对肾移植术后稳定期患者移植后肾功能的临床效果。 方法 选取2017年7月至2019年1月收治的96例肾移植稳定期患者作为研究对象，按照简单随机法分为对照组和治疗组，每组各为48例，两组分别给予常规免疫抑制治疗，治疗组加用贝前列素钠20 μg，tid，持续1年，比较两组血肌酐（SCr），胱抑素C（Cys-C），尿微量白蛋白（MAU），尿蛋白肌酐比值（UREA）变化，通过彩超比较肾脏血流变化。 结果 治疗组肾移植术1年后血肌酐、Cys-C、尿MAU、UAER下降，与对照组相比，差异有统计学意义（P<0.05）;在肾脏血液供应方面有改善，差异有统计学意义（P<0.05）。 结论 肾移植术后稳定期长期免疫抑制治疗患者加用贝前列素钠治疗可进一步增加肾脏血供，降低尿微量白蛋白，改善肾功能。

[关键词] 贝前列素鈉;肾移植术后稳定期;肾脏血流;肾脏功能

[中图分类号] R699.2          [文献标识码] B          [文章编号] 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

慢性肾脏病（Chronic kidney disease，CKD）已成为全球关注的公共健康问题，发病率居高不下，随着人口老龄化、糖尿病、动脉硬化等因素导致CKD患者进入终末期肾病（End-stage renal disease，ESRD）逐步增加。腹膜透析、血液透析、肾移植是ESRD患者常用肾替代选择。临床上，肾移植术是ESRD患者优选的替代治疗方法，无论是否合并糖尿病，都能显著提高患者生活质量，延长患者生存时间[1]，并减少医疗费用，为最常见且管理成熟的器官移植手术之一，如何让移植肾保持长期稳定，是临床医生考虑的方向。