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目的观察阿托伐他汀对血脂代谢正常的早期糖尿病肾病患者炎性因子水平的影响。方法血脂水平正常糖尿病肾病(diabetic nephropathy,DN)患者30例,随机分为治疗组(DT组)和病例对照组(DN组)各15例,同期15例单纯2型糖尿病患者为非DN对照组(DM组),15例体检健康者为正常对照组(NC组)。NC组给予健康生活方式指导,DT组、DN组和DM组在健康生活方式指导同时给予降糖、降压等基础临床干预,DT组加用阿托伐他汀20mg/次,睡前口服。分别于干预前及干预3个月后测定4组血清高敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)水平,测定尿白蛋白排泄率(urinary albumin excretion rate,UAER)并进行比较。结果干预前DN、DT组hs-CRP、TNF-α、IL-6水平均高于DM组、NC组(P<0.05),DN与DT组、DM组与NC组各指标比较差异无统计学意义(P>0.05);DT组干预后hs-CRP、TNF-α水平较干预前降低(P<0.05);DT组干预后hs-CRP、TNF-α、IL-6水平低于DN组(P<0.05),高于NC组(P<0.05),与DM组比较差异无统计学意义(P>0.05);干预后DT组UAER降低(P<0.05),并低于DN组(P<0.05),高于DM组和NC组(P<0.05)。结论 阿托伐他汀可改善早期DN患者微炎症状态,降低UAER。
Objective To observe the effect of atorvastatin on the levels of inflammatory cytokines in patients with early diabetic nephropathy with normal lipid metabolism. Methods Thirty patients with normal diabetic nephropathy (DN) were randomly divided into treatment group (DT group) and control group (DN group), 15 cases each. In the same period, 15 cases of type 2 diabetic patients were non-DN control group (DM group) and 15 healthy subjects were normal control group (NC group). NC group were given healthy lifestyle guidance. DT group, DN group and DM group were given basic clinical interventions such as hypoglycemic and antihypertensive guidance under healthy lifestyle guidance. Atorvastatin 20 mg / time was added to DT group, which was orally taken at bedtime. The serum levels of high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α) and interleukin The level of interleukin-6 (IL-6) was measured and the urinary albumin excretion rate (UAER) was measured and compared. Results The levels of hs-CRP, TNF-α and IL-6 in DN group and DT group before intervention were higher than those in DM group and NC group (P <0.05). There was no significant difference between DN group, DT group, DM group and NC group (P <0.05). The levels of hs-CRP and TNF-α in DT group were lower than those in pretreatment group (P <0.05). The levels of hs-CRP, TNF-α and IL-6 in DT group were lower than those in DN group (P <0.05), higher than NC group (P <0.05), but there was no significant difference between DM group and DM group (P> 0.05) 0.05), higher than DM group and NC group (P <0.05). Conclusions Atorvastatin can improve microinflammatory state and reduce UAER in patients with early DN.