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目的:观察氟伐他汀对早期糖尿病肾病患者高敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、尿微量白蛋白排泄率(UAER)和血清肌酐(Cr)的影响。方法:69例早期糖尿病肾病患者随机分为观察组34例(低蛋白饮食+氟伐他汀)和对照组35例(低蛋白饮食),两组患者疗程均为8周,分别于治疗前后检测hs-CRP、TNF-α、UAER、ALT、Cr水平,并与同期另设的正常组65例的上述指标水平进行比较。结果:与治疗前相比,对照组治疗后UAER水平明显下降(P<0.05);hs-CRP、TNF-α水平下降不明显(P>0.05);观察组治疗后UAER、hs-CRP、TNF-α水平均明显下降(P<0.05或0.01),且明显低于低于对照组同期(P<0.05或0.01)。两组治疗前后ALT、Cr变化差异无统计学意义(P>0.05),但治疗8周时观察组Cr明显低于对照组(P<0.05)。观察组、对照组在治疗前后UAER、hs-CRP、TNF-α均明显高于正常组(P<0.05);ALT、Cr与正常组比较差异无统计学意义(P>0.05)。结论:UAER、hs-CRP、TNF-α与糖尿病肾病密切相关,氟伐他汀与低蛋白饮食联合治疗早期DN,可显著抑制炎症因子hs-CRP、TNF-α,降低UAER。
OBJECTIVE: To observe the effect of fluvastatin on high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), urinary albumin excretion (UAER) and serum creatinine (Cr) in patients with early diabetic nephropathy . Methods: Sixty-nine patients with early diabetic nephropathy were randomly divided into observation group of 34 cases (low protein diet + fluvastatin) and control group of 35 cases (low protein diet), the two groups of patients were treated for 8 weeks, respectively, before and after treatment detected hs -CRP, TNF-α, UAER, ALT and Cr levels were compared with those in the normal control group (n = 65). Results: The levels of UAER in the control group decreased significantly (P <0.05) and the levels of hs-CRP and TNF-α in the control group decreased significantly (P 0.05). The levels of UAER, hs-CRP, TNF -α levels were significantly decreased (P <0.05 or 0.01), and significantly lower than the control group at the same period (P <0.05 or 0.01). There was no significant difference in ALT and Cr between the two groups before and after treatment (P> 0.05). However, the Cr level in the observation group was significantly lower than that in the control group at 8 weeks (P <0.05). The levels of UAER, hs-CRP and TNF-α in the observation group and the control group before and after treatment were significantly higher than those in the normal control group (P <0.05). There was no significant difference in ALT and Cr between the two groups (P> 0.05). Conclusions: UAER, hs-CRP and TNF-α are closely related to diabetic nephropathy. Combination of fluvastatin and low protein diet can significantly inhibit the expression of hs-CRP and TNF-α and decrease UAER in early DN.