不同他汀类药物改善老年高血压患者早期肾损害的效果

摘要

目的 探讨不同他汀类药物对老年高血压患者早期肾损害的干预效果.方法 选择2014年1月～2015年6月在浙江省嘉善县第一人民医院心内科住院或门诊就诊的老年高血压合并早期肾功能损害患者120例,采用随机数字表法分为阿托伐他汀组、瑞舒伐他汀组、辛伐他汀组、对照组,各30例.对照组予常规降压治疗,其余三组在常规降压治疗的基础上分别予对应他汀类药物治疗.比较各组治疗前后血肌酐(Scr)、肾小球滤过率(eGFR)、血β2-微球蛋白(β2-MG)、尿微量白蛋白(mALB)、血脂、高敏C反应蛋白(hs-CRP)水平变化.结果 治疗后阿托伐他汀组、瑞舒伐他汀组、辛伐他汀组血总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、血β2-MG、mALB、hs-CRP水平较治疗前及对照组显著性下降(P＜0.05),高密度脂蛋白胆固醇(HDL-C)较治疗前及对照组升高(P＜0.05);阿托伐他汀组在降低血β2-MG、mALB、hs-CRP水平方面明显优于瑞舒伐他汀组和辛伐他汀组(P＜0.05);治疗前后各组Scr,eGFR均未见明显变化(P＞0.05).结论 阿托伐他汀、瑞舒伐他汀、辛伐他汀均能改善老年高血压合并早期肾功能损害程度.%Objective To investigate the intervention effect of different statins for early renal damage in elderly patients with hypertension.Methods 120 cases of patients treated in Department of Cardiology,the First People's Hospital of Jiashan County in Zhejiang Province from January 2014 to June 2016 were selected and randomly divided into the Atorvastatin group,Rosuvastatin group,Simvastatin group and control group,according to the random nunber table,30 cases in each group.Patients in the control group were given routine therapy,and the other three groups were added with statins therapy on the basis of conventional antihypertensive therapy.All groups were compared of serum Scr,eGFR,β2-MG,mALB,blood lipids and hs-CRP before and after treatment.Results After therapy,the levels of TC,TG,LDL-C,β2-MG,mALB and hs-CRP in the Atorvastatin group,Rosuvastatin group and Simvastatin group significantly decreased than before treatment and the control group (P ＜ 0.05);and the levels of HDL-C were higher than before treatment and the control group (P ＜ 0.05).Atorvastatin group in reducing levels of β2-MG,mALB were better than those of the Rosuvastatin group and Simvastatin group (P ＜ 0.05).The levels of eGFR and Scr were not significantly changed in each group before and after treatment (P ＞ 0.05).Conclusion Atorvastatin,Simvastatin and Simvastatin can improve the degree of early renal damage in elderly patients with hypertension.