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目的 探讨氟伐他汀治疗糖尿病肾病 (DN)的疗效及其抗炎机制。方法 选择 2 0 0 0 - 0 2～ 2 0 0 3- 0 6广东省东莞市人民医院门诊及住院的 14 0例早期DN患者随机分为治疗组和对照组。对照组给予常规治疗 ,治疗组每晚加服氟伐他汀 4 0mg。比较两组治疗前及治疗后 3、6、9个月的尿白蛋白排泄率 (UAER)、血肌酐 (Scr)和反应蛋白 (CRP)等指标。结果 治疗组UAER和Scr下降比对照组明显 (P <0 0 5 ,P <0 0 1) ,起效更快 (早 3个月 ) ;治疗组CRP明显下降 (P <0 0 5 ,P <0 0 1) ,而对照组CRP下降不明显 (P >0 0 5 )。而且 ,对两组中血脂正常的DN患者进行比较分析也得出类似的结果。结论 氟伐他汀因降低CRP的抗炎效应而减轻微量白蛋白尿和改善肾功能 ,该作用不依赖氟伐他汀的降血脂效应
Objective To investigate the curative effect and anti-inflammatory mechanism of fluvastatin on diabetic nephropathy (DN). Methods A total of 140 patients with early stage DN who were outpatient and inpatient in Dongguan People’s Hospital of Guangdong Province were randomly divided into treatment group and control group. Control group given conventional treatment, the treatment group plus fluvastatin 40mg per night. Urinary albumin excretion rate (UAER), serum creatinine (Scr) and reactive protein (CRP) were measured before and 3,6 and 9 months after treatment. Results The decrease of UAER and Scr in the treatment group was more obvious than that in the control group (P <0.05, P <0.01), and the onset was faster (as early as 3 months). CRP in the treatment group was significantly decreased (P <0.05, P < 0 0 1), while CRP did not decrease in the control group (P> 0.05). Moreover, a comparative analysis of DN patients with normal blood lipids in both groups also yielded similar results. Conclusions Fluvastatin can reduce microalbuminuria and improve renal function by decreasing the anti-inflammatory effect of CRP, which is not dependent on the hypolipidemic effect of fluvastatin