J Hypertens:血管舒张剂β受体阻滞剂对高血压患者肾功能的影响!

2017-06-28 xing.T MedSci原创

由此可见,VBBs不影响肾小球滤过率或肌酐水平,但会减少蛋白质的排泄。这类β受体阻滞剂,然而,在减少尿蛋白上并不优于非VBBs。VBBs降低RVR的程度显著大于非VBBs。

针对血管扩张剂β受体阻滞剂(VBB)对肾功能影响的研究不仅数量有限,对肾功能的衡量是通过肾小球滤过率(GFR)、血清肌酐(sCR)、蛋白尿等,并且这些报道的结果并不一致。近日,高血压领域权威杂志Journal of Hypertension上发表了一篇荟萃分析文章,该荟萃分析旨在评估VBBs对高血压患者选择的肾功能参数的效应。

研究人员对提供了基线和随访至少4周的VBBs治疗,包括卡维地洛、地来洛尔、拉贝洛尔、塞利洛尔、比索洛尔,的任何前瞻性的临床试验进行了一项荟萃分析。研究人员检索了Ovid MEDLINE、MEDLINE、EMBASE和PubMed,且没有日期限制。研究人员共纳入39项研究,共计3987名患者。

虽然VBBs在至少4周的治疗后并没有显著改变肾小球滤过率或肌酐水平,它们明显降低了-0.12个SD单位的蛋白排泄[95%可信区间(CI)为-0.19至-0.04;P<0.01]。VBBs并没有改变肾脏血流量或血浆流量,但肾血管阻力(RVR)下降了-20.03mmHg min/L(95%CI为-28.92到-11.15;P<0.01)。在比较VBBs与非VBBs的分析中,唯一显著的区别是VVB组患者RVR降低程度更大为-38.44mmHg min/L(95%CI为-60.57到-16.31;P<0.01)。

由此可见,VBBs不影响肾小球滤过率或肌酐水平,但会减少蛋白质的排泄。这类β受体阻滞剂,然而,在减少尿蛋白上并不优于非VBBs。VBBs降低RVR的程度显著大于非VBBs。

原始出处:

Kwon, Lawrence H;et al. The effect of vasodilator [beta]-blockers on renal function in hypertensive patients.Journal of Hypertension. 2017. http://journals.lww.com/jhypertension/Abstract/publishahead/The_effect_of_vasodilator__beta__blockers_on_renal.97684.aspx

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    2018-01-05 zhyy88
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createdName=有备才能无患, createdTime=Wed Jun 28 20:39:15 CST 2017, time=2017-06-28, status=1, ipAttribution=)]
    2018-02-04 feather89
  5. 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  6. 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  7. 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  8. 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createdName=有备才能无患, createdTime=Wed Jun 28 20:39:15 CST 2017, time=2017-06-28, status=1, ipAttribution=)]
    2017-06-28 有备才能无患

    VBBs不影响肾小球滤过率或肌酐水平,但会减少蛋白质的排泄。这类β受体阻滞剂,然而,在减少尿蛋白上并不优于非VBBs。VBBs降低RVR的程度显著大于非VBBs。

    0