阿托伐他汀对糖尿病肾病患者炎症状态的影响
Effects of atorvastatin on inflammation in patients with diabetic nephropathy
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摘要: 目的:观察阿托伐他汀对糖尿病肾病患者血清C反应蛋白(CRP)、单核细胞趋化蛋白-1(MCP-1)及尿白蛋白排泄率(UAER)的影响。方法:糖尿病肾病患者108例,随机均分为一般治疗组和阿托伐他汀治疗组。其中一般治疗组仅给予一般性治疗(包括控制血糖、血压等),阿托伐他汀治疗组给予一般治疗加阿托伐他汀40 mg/d,共观察12周。另取20名健康体检者作为对照组。所有研究对象分别于治疗前及治疗4周、8周、12周后各采静脉血1次,测定血清CRP、MCP-1和代谢指标空腹血糖、血脂(总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯),并采集24 h尿检测UAER。结果:阿托伐他汀治疗组血浆CRP、MCP-1及UAER水平在治疗前与一般治疗组患者差异均无统计学意义(P>0.05),在治疗后均明显低于一般治疗组(P<0.01),且随着治疗时间的延长,阿托伐他汀治疗组血浆CRP、MCP-1及UAER水平均有明显降低(P<0.01);血浆CRP、MCP-1与UAER均呈正相关关系(P<0.01)。结论:阿托伐他汀可能通过抑制炎症反应而保护糖尿病肾病患者的肾脏功能。Abstract: Objective:To observe the effect of atorvastatin on creactive protein (CRP),monocyte chemoattractant protein-1 (MCP-1) and urinary albumin excretion rate (UAER) in patients with diabetic nephropathy (DN).Methods:One hundred and eight DN patients were randomly divided into treatment group (54 cases) and atorvastatin group (54 cases).The treatment group were administered the routine therapy and the atorvastatin group received atorvastatin 40 mg daily.The therapies lasted for 12 weeks in both groups.Twenty healthy people acted as control.Serum CRP,MCP-1,glucose,lipids levels and UAER were compared between the two groups before treatment and 4,8,12 weeks after treatment.Results:Levels of plasma CRP,MCP-1 and UAER had no obvious difference between the two groups before treatment (P>0.05),but the above levels decreased significant in atorvastatin group after the therapy (P<0.01).Serum CRP,MCP-1 and UAER presented a positive correlation (P<0.01).Conclusions:Atorvastatin could effectively decrease the urinary protein excretion by restraining inflammation in DN patients.