瑞舒伐他汀对血脂正常的早期糖尿病肾病患者肾脏保护作用观察

摘要

目的 观察瑞舒伐他汀对血脂正常的早期糖尿病肾病(DN)患者肾脏的作用.方法 62例早期DN患者完全随机分为研究组和对照组,各31例.对照组给予常规降糖治疗及厄贝沙坦150 nmg,2次/d.研究组在对照组治疗基础上,给予瑞舒伐他汀10 mg/d,口服,共12周.治疗前及治疗12周后测定2组患者空腹血清TC、HDL-C、LDL-C、TG、高敏C反应蛋白(hs-CRP)、糖化血红蛋白(HbAlc)、BUN、Cr、尿酸、ALT、AST及肌酸激酶(CK)水平,检测24h尿白蛋白排泄率(UEAR)和尿β2微球蛋白(β2MG).结果 2组治疗前后TC、HDL-C、LDL-C、TG、HbAlc、ALT、AST及CK水平差异均无统计学意义；与治疗前比较,2组治疗后尿β2 MG、UEAR均明显下降[(o.3±0.1) mg/L比(0.6±0.2) mg/L,(0.4士0.1)mg/L比(0.6±0.2) mg/L；( 132.6±14.2) mg/24 h比(206.1±19.7)mg/24 h,(162.2±18.5) mg/24 h比(203.2±21.4) mg/24 h,均P＜0.05],研究组hs-CRP水平也明显降低[(3.6±1.6)mg/L比(4.5±1.5) mg/L,P＜0.05],但研究组尿β2MG、UEAR及hs-CRP下降幅度较对照组明显(P＜0.05).结论 瑞舒伐他汀具有非依赖降脂的肾保护作用机制.%Objective To observe the role of rosuvastatin on early diabetic nephropathy(DN) with normal blood lipid.Methods Sixty-two cases of type 2 diabetes patients with early DN were randomly divided into study group( rosuvastatin with erbesartan) and control group (erbesartan only).The level of fasting serum cholesterol (TC),high-density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol(LDL-C),triglycerides (TG),high sensitive C-reactive protein (hs-CRP),glycated hemoglobin ( HbA l c ),urea nitrogen ( BUN ),creatinine(Cr),uric acid(UA),alanine amino transaminase(ALT),aspartic transaminase(AST) and creatine kinase (CK) were determined before and after treatment for12 weeks.Results Before and after treatment,the changes of TC,HDL-C,LDL-C,TG,HbAlc,ALT,AST and CK in two groups had no statistically significant differences.After treatment,the comparison between the two groups also had no obvious difference ( P ＞ 0.05 ).β2 MG,UEAR in study group and control group descended significantly after treatment[(0.3 ± 0.1 ) mg/L vs (0.6 ± 0.2) mg/L,(0.4±0.l)mg/L vs (0.6 ±0.2)mg/L;(132.6 ± 14.2)mg/24 h vs (206.1 ± 19.7)mg/24 h,(162.2±18.5)mg/24 h vs (203.2 ± 21.4) mg/24 h,P ＜ 0.05 ],hs-CRP in the study group also reduced significantly[( 3.6 ±1.6) mg/L vs (4.5 ± 1.5 ) mg/L,P ＜ 0.05 ].β2 MG,UEAR and hsCRP of the study group descended significantly (P ＜ 0.05).Conclusion Rosuvastatin is an independent factor on lipid-lowering renal defense mechanism.