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目的 观察奥美沙坦及叶酸对于维持性血液透析患者微炎症状态的干预.方法 39例患者随机分为三组:A组(n=13)常规维持性血液透析,B组(n=13)常规维持性血液透析并口服奥美沙坦,C组(n=13)常规维持性血液透析并口服叶酸.治疗8周并观察治疗前后血肌酐、左心室收缩末期内径、左室射血分数、同型半胱氨酸、高敏C-反应蛋白的变化.结果 8周后三组肾小球滤过率均小于10 mL/min,且三组左心室收缩末期内径无改善.口服奥美沙坦组对于左室射血分数、高敏C-反应蛋白变化差异有统计学意义.口服叶酸组对于高敏C-反应蛋白无明显改善,却可以降低同型半胱氨酸水平.结论 维持性血液透析患者分别给予奥美沙坦、叶酸8周口服药物干预,口服奥美沙坦组可以提高左室射血分数及降低高敏C-反应蛋白.口服叶酸组可以降低同型半胱氨酸,而对于左室射血分数及降低高敏C-反应蛋白无改善作用.“,”Objective To observe the intervention of olmesartan and folic acid for microinflammatory state in maintenance hemodialysis patients. Methods 39 cases were randomly divided into group A (n=13) of maintenance hemodialysis, group B (n=13) oraled olmesartan with maintenance of hemodialysis, group C (n=13) oraled folic acid with maintenance hemodialysis. The changes of left ventricular end systolic diameter, left ventricular ejection fraction, homocysteine, high sensitive C reactive protein were observed in 8 weeks treatment. Results During 8 weeks treatment, the glomerular filtration rate of three groups were less than 10 mL/min, and the left ventricular end systolic diameter were not improved in the three groups. There were statistical differences in oraled olmesartan of left ventricular ejection fraction and hs-CRP. There was no change of hs-CRP in group for oraled folic acid, but homocysteine levels could be decreased. Conclusion During 8 weeks treatment of patients with maintenance hemodialysis, left ventricular ejection fraction was improved and hs-CRP could be decreased in oraled olmesartan group. The homocysteine could be reduced in oraled folic acid group, but there was no effect in left ventricular ejection fraction and decreased hs-CRP.