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目的:观察血清胱抑素C(Cystatin C,Cys C)在阿托伐他汀治疗早期心肾综合征中的变化,探讨Cys C在阿托伐他汀治疗早期心肾综合征中的临床意义。方法:选择90例慢性心功能不全引起的早期心肾综合征患者,随机分为常规治疗组(A组)、阿托伐他汀20 mg组(B组)以及阿托伐他汀40 mg组(C组)各30例。常规治疗组给予常规抗心力衰竭药物治疗,阿托伐他汀组在常规抗心衰药物治疗基础上分别加用阿托伐他汀20 mg/d或者阿托伐他汀40 mg/d口服。分别测定其治疗3个月前后Scr、GFR、Cys C水平并进行组间比较。结果:治疗3个月后,A组、B组Scr及GFR分别与治疗前比较差异无显著性(P>0.05),C组Scr及GFR与治疗前比较差异有显著性(P<0.05);治疗3个月后,A组Cys C与治疗前比较差异无显著性(P>0.05),B组、C组Cys C与治疗前比较差异有显著性(P<0.01)。结论:在阿托伐他汀治疗早期心肾综合征疗效观察中,Cys C较Scr更能敏感反应早期肾功能变化情况。
Objective: To observe the changes of serum cystatin C (Cys C) in atherosclerotic heart failure patients treated with atorvastatin and to explore the clinical significance of Cys C in atorvastatin treatment of early cardiorenal syndrome. Methods: Ninety patients with early cardiorespiratory syndrome caused by chronic heart failure were randomly divided into routine treatment group (A group), atorvastatin 20 mg group (B group) and atorvastatin 40 mg group (C Group) of 30 cases each. The patients in the conventional treatment group were given routine anti-heart failure drug treatment. Atorvastatin group was given oral atorvastatin 20 mg / day or atorvastatin 40 mg / day on the basis of conventional anti-heart failure drug treatment. The levels of Scr, GFR and Cys C before and 3 months after treatment were measured and compared between groups. Results: After 3 months of treatment, the Scr and GFR in group A and B were not significantly different from those before treatment (P> 0.05). Scr and GFR in group C were significantly different from those before treatment (P <0.05). After 3 months of treatment, the Cys C in group A was not significantly different from that before treatment (P> 0.05). The Cys C in group B and group C was significantly different from that before treatment (P <0.01). CONCLUSIONS: Cys C is more sensitive to early renal function changes in response to atorvastatin compared with Scr in early cardiorenal syndrome.