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目的探讨维持性血液透析(MHD)患者应用辛伐他汀治疗对患者心血管系统、炎症反应状态的影响,为临床治疗提供参考依据。方法选取2014年1月至2016年1月天津市第五中心医院常规行MHD的84例患者为研究对象,依据患者是否使用辛伐他汀治疗,将患者分为对照组和辛伐他汀组,每组42例。对照组采取每周行常规MHD治疗2~3次,辛伐他汀治疗组患者在此基础上口服辛伐他汀,剂量为20 mg,每晚睡前1次,疗程12周。检测两组患者治疗前、后血清脑利钠肽(BNP)、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(c Tn I)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、血肌酐(SCr)和尿素氮(BUN)的水平。用SPSS 16.0进行统计分析,计量资料两组间比较用独立样本t检验。结果治疗前,辛伐他汀组和对照组的血清BNP、CK-MB和c Tn I水平差异均无统计学意义(P>0.05);治疗后,辛伐他汀组的血清BNP、CK-MB和c Tn I水平均低于对照组,差异均有统计学意义(P<0.01)。治疗前,辛伐他汀组和对照组的血清CRP、IL-6、IL-1、TNF-α和IL-8水平差异无统计学意义(P>0.05);治疗后,辛伐他汀组血清CRP、IL-6、IL-1、TNF-α和IL-8水平均低于对照组,差异均有统计学意义(P<0.01)。结论 MHD患者加用辛伐他汀对患者心血管系统具有保护作用,减轻患者的炎症反应。
Objective To investigate the effect of simvastatin on the cardiovascular system and inflammatory response in maintenance hemodialysis (MHD) patients and provide reference for clinical treatment. Methods From January 2014 to January 2016, 84 patients with routine MHD in the Fifth Central Hospital of Tianjin were enrolled. Patients were divided into control group and simvastatin group according to whether they were treated with simvastatin or not. Group of 42 cases. Patients in the simvastatin group were given simvastatin orally at a dose of 20 mg once a day at bedtime for 12 weeks. The levels of serum brain natriuretic peptide (BNP), creatine kinase (CK-MB), cTn I, C-reactive protein (CRP) and interleukin- 6, IL-1, TNF-α, IL-8, SCr and BUN )s level. SPSS 16.0 statistical analysis, measurement data between two groups using independent samples t test. Results Before treatment, the serum levels of BNP, CK-MB and cTn I in simvastatin group and control group were not significantly different (P> 0.05). After treatment, the levels of serum BNP, CK-MB and cTn I levels were lower than the control group, the difference was statistically significant (P <0.01). Before treatment, there was no significant difference in serum CRP, IL-6, IL-1, TNF-α and IL-8 levels between simvastatin group and control group (P> 0.05) , IL-6, IL-1, TNF-α and IL-8 in the control group were significantly lower than those in the control group (P <0.01). Conclusions Patients with MHD and simvastatin have a protective effect on the cardiovascular system and relieve the patient’s inflammatory response.