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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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慢性病患者的维生素D治疗和心脏结构和功能:PRIMO随机对照试验
Ravi Thadhani1, Evan Appelbaum, Yili Pritchett
1Division of Nephrology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA. thadhani.r@mgh.harvard.edu
JAMA
|February 17, 2012
概括
活性维生素D化合物帕里卡尔西托尔 (paricalcitol) 在患有慢性病的患者中,在48周内没有减少左心室质量. 这项研究也没有发现扩张性功能障碍的改善,随着高血症风险的增加.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
背景情况:
- 建议维生素D在心血管健康中的潜在作用,但缺乏强有力的证据.
- 慢性病 (CKD) 患者通常会出现心血管并发症.
- 左心室缩 (LVH) 在CKD中很常见,并且与不良结果有关.
研究的目的:
- 调查帕里卡尔西托尔对CKD患者左心室质量的作用.
- 评估帕里卡尔西托尔对这种人群的透静功能的影响.
- 评估安全性,包括高血症风险.
主要方法:
- 一个跨国,双盲,随机的安慰剂受控试验,涉及227名CKD患者.
- 参与者在48周内接受了口服帕里卡尔西托尔 (2μg/d) 或安慰剂.
- 使用心血管磁共振成像测量左心室质量指数;通过心声回声学评估腹功能.
主要成果:
- 帕里卡尔西托尔有效降低了副甲状腺激素水平,但与安慰剂相比,它没有显著改变左心室质量指数.
- 两组之间在多普勒测量透气功能的测量中没有发现显著差异.
- 超血症发作在帕里卡尔西托尔组中更为频繁.
结论:
- 在CKD患者中,四十八周的帕里卡尔西托尔治疗没有改变左心室质量指数.
- 在本研究人群中,帕里卡尔西托尔并没有改善腹筋功能障碍的指标.
- 这些发现表明,在CKD心脏重塑中,帕里卡尔西托尔对心脏的益处有限,高血症风险增加.
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