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目的探讨阿托伐他汀对老年慢性肾病伴高脂血症患者控脂水平及致炎因子的影响。方法选取南阳医专第一附属医院2015年1月—2016年1月收治的78例老年慢性肾病伴高脂血症患者为研究对象,随机分为观察组和对照组,每组39例。两组患者均予生活、饮食、抗凝、标准激素治疗,观察组在此基础上加用阿托伐他汀治疗。检测和比较两组治疗前后血脂指标水平、致炎因子指标水平,并观察两组治疗期间不良反应发生情况。采用SPSS19.0统计软件进行统计分析,计量资料用均数±标准差(xˉ±s)表示,采用t检验,计数资料用率(%)表示,采用χ2检验,P<0.05为差异有统计学意义。结果治疗前两组血清胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C),高密度脂蛋白胆固醇(HDL-C)水平比较,差异无统计学意义(P>0.05),治疗后观察组TC、TG、LDL-C水平依次为(4.23±1.14)、(2.07±0.41)、(0.92±0.04)mmol/L明显低于对照组,HDL-C水平(1.37±0.52)mmol/L明显高于对照组(P<0.05);治疗前两组尿蛋白定量、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)比较,差异无统计学意义(P>0.05),治疗后观察组尿蛋白定量、TNF-α、CRP依次为(1.13±0.83)g/24 h、(1.11±0.21)μg/L、(8.31±0.28)mg/L均显著低于对照组(P<0.05);两组患者在用药过程中均未出现明显的临床不适症状。结论阿托伐他汀可显著调节老年肾病伴高脂血症患者的血脂水平,降低致炎因子水平,对控脂及缓解患者病情有重要意义。
Objective To investigate the effects of atorvastatin on blood lipid levels and proinflammatory cytokines in elderly patients with chronic kidney disease and hyperlipidemia. Methods A total of 78 elderly patients with chronic kidney disease and hyperlipidemia admitted to the First Affiliated Hospital of Nanyang Medical College from January 2015 to January 2016 were selected as study subjects and randomly divided into observation group and control group with 39 cases in each group. Both groups were given life, diet, anticoagulation and standard hormone therapy. The observation group was treated with atorvastatin on this basis. The level of serum lipids and the level of inflammatory cytokines were measured and compared before and after treatment. The incidence of adverse reactions in the two groups were observed. Using SPSS19.0 statistical software for statistical analysis, measurement data with mean ± standard deviation (x ˉ ± s), using t test, the count data (%) that the use of χ2 test, P <0.05 was statistically significant significance. Results There was no significant difference in the levels of serum TC, TG, LDL-C and HDL-C between the two groups before treatment (P> 0.05). After treatment, the levels of TC, TG and LDL-C in the observation group were (4.23 ± 1.14), (2.07 ± 0.41) and (0.92 ± 0.04) mmol / L, 0.52) mmol / L was significantly higher than that of the control group (P <0.05). There was no significant difference in urinary protein, tumor necrosis factor-α and C-reactive protein between the two groups before treatment > 0.05). After treatment, the urinary protein in the observation group was significantly lower than that of the control group (1.13 ± 0.83 g / 24 h, 1.11 ± 0.21 μg / L and (8.31 ± 0.28) mg / L, Control group (P <0.05). No obvious clinical symptoms were found in both groups during the course of medication. Conclusions Atorvastatin can significantly regulate blood lipids and reduce the level of inflammatory cytokines in elderly patients with nephropathy and hyperlipidemia, which is of great importance to the control of lipids and the severity of the disease.