摘要
目的探讨血管紧张素转换酶抑制剂依那普利对移植肾远期功能的保护作用。方法对肾移植术后存活超过1年、移植肾功能正常、尿转化生长因子β1(TGFβ1)相对浓度≥250.0pg/mgCr者连续使用依那普利1年以上,并设立相同条件下不用依那普利的对照组,3年后比较两组发生肾功能异常的例数、肌酐清除率(Ccr)的减少量、血及尿中TGFβ1的浓度;观察服用依那普利前后移植肾组织中TGFβ1mRNA表达量的变化以及服用依那普利的不良反应。结果3年后,使用依那普利者发生肾功能异常的例数明显低于对照组(P<0.05),Ccr减少量及尿TGFβ1相对浓度也明显低于对照组(P<0.01,P<0.01),但两个组血TGFβ1浓度的差异无统计学意义;服用依那普利1年后,移植肾组织中TGFβ1mRNA表达量显著降低(P<0.01);发生肾功能异常者,移植肾组织呈现慢性移植肾肾病表现;未观察到与依那普利相关的不良反应。结论依那普利对移植肾的远期功能具有保护作用,其作用机理可能与依那普利抑制TGFβ1分泌有关。
Objective To observe the protective effects of enalapril on the long-term functions of the allograft in renal transplant recipients. Methods Twenty renal transplant recipients with ~survival time over one year, normal renal functions of the allograft and urine TGF-β_1 levels being more than ~250.0 pg/mg.Cr took enalapril every day for at least one year. Twenty-three recipients under the same conditions who did not receive enalapril served as control group. Three years later renal ~dysfunction cases, loss of creatinine clearance rate (Ccr) and TGF-β_1 levels in blood and urine were compared between the two groups. The changes in the expression of TGF-β_1mRNA in renal biopsy specimens were compared before and one year after enalapril therapy. Side-effects of enalapril were ~investigated in all patients in enalapril-treated group. Results Three years later, the number of renal dysfunction cases was less, the loss of Ccr was less and the level of urine TGF-β_1 was lower in ~enalapril -reated group than those in control group with the differences being significant (P<~0.05 , <~0.01 , <~0.01 respectively). No significant difference was found in blood TGF-β_1 levels between the two groups (P>~0.05 ). One year after enalapril therapy TGF-β_1mRNA expression was significantly decreased in renal biopsy specimens (P<~0.01 ). Chronic allograft nephropathy (CAN) was ~biopsy-proven in all patients with renal dysfunction. No side-effects were noted in all patients who had taken enalapril. Conclusion Enalapril have an effect to protect renal allograft long-term function, which was contributed to the reduction of the TGF-β_1 secretion by enalapril.
出处
《中华器官移植杂志》
CAS
CSCD
北大核心
2005年第1期14-16,共3页
Chinese Journal of Organ Transplantation
关键词
依那普利
移植肾
远期功能
保护作用
Kidney transplantation
Enalapril
Transforming growth factor beta
Cytoprotection
