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背景:羟苯磺酸钙作为一种血管保护剂被广泛用于治疗慢性静脉功能不全和糖尿病肾病,尤其大量临床研究表明它可以减轻糖尿病肾病的肾损害,但很少有关于羟苯磺酸钙用于治疗肾移植后慢性移植肾功能不全的文献报道。目的:观察羟苯磺酸钙治疗慢性移植肾功能不全的有效性和安全性。方法:收集解放军第二军医大学附属长征医院全军器官移植研究所收治的152例肾移植后出现慢性移植肾功能不全的患者,分为治疗组(n=78)和对照组(n=74)。治疗组患者口服羟苯磺酸钙500 mg 3次/d,连续服用8周。所有患者均接受钙调磷酸酶抑制剂为基础的免疫抑制方案和综合治疗。结果与结论:对于服用羟苯磺酸钙治疗的患者,其血肌酐、尿素氮和尿酸在治疗第2周时均较治疗前明显下降并维持稳定(P<0.05),但血肌酐和尿素氮在停药后立即回复到原基线水平。而两组患者的血常规、肝功能、血脂、电解质、血压及24 h尿量在治疗前后差异均无显著性意义(P>0.05)。服用羟苯磺酸钙并不会对肾功能不全患者的一般情况和免疫抑制剂的血药浓度产生影响。羟苯磺酸钙可能通过自身与血肌酐结合、减轻微循环损伤及其抗氧化的特性延缓慢性移植肾功能不全的进展。同时,服药后血肌酐下降有助于缓解患者的焦虑和担忧。然而,羟苯磺酸钙对血肌酐检测的负性干扰需引起重视,以免对患者病情产生误判。
BACKGROUND: Calcium dobesilate is widely used as a vasoprotective agent in the treatment of chronic venous insufficiency and diabetic nephropathy. In particular, a large number of clinical studies have shown that it can reduce renal damage in diabetic nephropathy. However, few studies have reported about calcium dobesilate Reported in the literature for the treatment of chronic allograft renal insufficiency after kidney transplantation. Objective: To observe the efficacy and safety of calcium dobesilate in the treatment of chronic allograft renal insufficiency. Methods: A total of 152 patients with chronic allograft renal insufficiency after renal transplantation were enrolled in the PLA General Hospital of Changzheng Hospital affiliated to PLA Second Military Medical University and divided into treatment group (n = 78) and control group (n = 74) . Patients in the treatment group were given calcium dobesilate 500 mg 3 times daily for 8 weeks. All patients underwent calcineurin inhibitor-based immunosuppression regimens and combined therapies. RESULTS AND CONCLUSION: Serum creatinine, urea nitrogen and uric acid in patients treated with calcium dobesilate were significantly decreased and remained stable (P <0.05) at the second week of treatment, but serum creatinine and urea nitrogen were stopped Immediately after the drug returned to the original baseline level. There was no significant difference between the two groups in blood routine, liver function, blood lipid, electrolyte, blood pressure and 24 h urine volume before and after treatment (P> 0.05). Taking calcium dobesilate does not affect the general condition of patients with renal insufficiency and the plasma concentration of immunosuppressive agents. Calcium dobesilate may delay the progress of chronic graft insufficiency by binding itself to serum creatinine, reducing microcirculation damage and its anti-oxidant properties. At the same time, decreased blood creatinine after taking medication helps to alleviate anxiety and anxiety in patients. However, calcium dobesilate on serum creatinine detection of negative interference need attention, so as not to mislead the patient’s condition.