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目的替米沙坦联合阿托伐他汀对早期糖尿病肾病(DN)微炎症状态的影响。方法早期DN患者40例均分为A组(替米沙坦80mg/d,口服)、B组(替米沙坦80mg/d+阿托伐他汀20mg/d,口服),疗程20周,采用ELISA检测核转录因子κB(NF-κB)p65亚基活性,生化检测仪检测血清炎症因子水平,RT-PCR和Western blot检测肾组织中NF-κB mRNA及蛋白表达情况。结果治疗后,两组各项检测指标均较治疗前明显降低(P<0.05),B组NF-κB p65亚基活性(0.56±0.03vs.1.31±0.05)、超敏C反应蛋白[(3.31±1.95)mg/L vs.(5.48±2.06)mg/L]、IL-1[(11.45±1.71)pg/ml vs.(14.48±1.75)pg/ml]、IL-6[(14.15±2.13)pg/ml vs.(16.19±2.15)pg/ml]、TNF-α[(20.69±4.45)pg/ml vs.(28.89±3.86)pg/ml]、NF-κB mRNA(0.546±0.013vs.0.780±0.012)及蛋白(0.451±0.021vs.0.743±0.031)表达水平改善均较A组更为明显(P<0.05)。结论替米沙坦联合阿托伐他汀可延缓早期DN的进展。
Objective To investigate the effect of telmisartan combined with atorvastatin on the microinflammatory state of early diabetic nephropathy (DN). Methods 40 patients with early DN were divided into group A (telmisartan 80mg / d, orally), group B (telmisartan 80mg / d + atorvastatin 20mg / d orally) for 20 weeks. The activity of NF-κB p65 subunit was detected. The level of serum inflammatory cytokines was detected by biochemical analyzer. The expression of NF-κB mRNA and protein in renal tissues was detected by RT-PCR and Western blot. Results After treatment, the detection indexes of both groups were significantly lower than those before treatment (P <0.05), while the activity of NF-κB p65 subunit in group B (0.56 ± 0.03 vs.1.31 ± 0.05), high sensitivity C reactive protein [(3.31 ± 1.95 mg / L vs. 5.48 ± 2.06 mg / L], IL-1 [(11.45 ± 1.71) pg / ml vs. (14.48 ± 1.75) pg / (20.69 ± 4.45) pg / ml vs. (28.89 ± 3.86) pg / ml], NF-κB mRNA (0.546 ± 0.013 vs. 0.780 ± 0.012) and protein (0.451 ± 0.021 vs.0.743 ± 0.031) were significantly higher than those in group A (P <0.05). Conclusion Telmisartan combined with atorvastatin can delay the progress of early DN.