糖尿病肾病动脉粥样硬化与血清脂联素的相关性及坎地沙坦联合阿托伐他汀的干预作用

摘要

Objective To study the relevance between adiponectin and diabetic nephropathy(DN)atherosclerosis(AS)and the intervention effect of candesartan combined with atorvastatin on it.Methods Totally 132 patients with DN were admitted to the hospital were divid-ed into the group A (with AS)and the group B (without AS),66 cases in each group,and the other 30 cases of healthy blood donors were selected as control group(group C).The FPG,HbA1C,TC,TG,HDL-C,LDL-C,SCr,BUN,24 h urine albumin quantitative and serum ADP levels were determined,the AIP and AI were calculated.The group B was given the treatment of candesartan and atorvas-tatin for 6 months,and the above indices were evaluate,the clinical efficacy was evaluated,and the incidence of adverse reactions was observed.Results The FPG,HbA1C,SCr,BUN and 24 h urinary protein in the group A and group B was significantly higher than those in the group C(P <0.05);the TC,TG,LDL-C,AI,AIP in the group C,group A,group B increased in turn(P <0.05),but the HDL-C and ADP levels decreased in turn(P <0.05);after 6-months treatment,the FPG,TC,TG,LDL-C,SCr,BUN,before 24 h urinary protein excretion,AI and AIP in group B were significantly lower than before treatment(P <0.05);but the HDL-C,ADP lev-els were significantly higher than before treatment(P <0.05);the effective rate was 96.97% and the adverse reaction rate was 22.73% in group B.Conclusion Serum ADP and DN atherosclerosis showed negative correlation,candesartan combined with atorvas-tatin in treating DN atherosclerosis has reliable effect,can reduce blood lipid levels,increase ADP levels,improve atherosclerosis,it is safety and worthy of clinical promotion.%目的：研究血清脂联素与糖尿病肾病动脉粥样硬化的相关性及坎地沙坦联合阿托伐他汀的干预作用。方法选择医院收治的糖尿病肾病患者132例，按是否合并动脉粥样硬化分为A组和B组，各66例，另选择健康献血者30例为正常对照组（C组）。测定3组空腹血糖（FPG）、糖化血红蛋白（HbA1C）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、血清肌酐（SCr）、尿素氮（BUN）、24 h尿白蛋白定量(24 h UKLB )及血清脂联素水平(ADP )，计算血浆致动脉粥样硬化指数（AIP）及动脉粥样硬化指数（AI）。B组患者给予坎地沙坦联合阿托伐他汀治疗6个月，检测上述指标的变化情况，评价临床疗效，并观察不良反应的发生情况。结果 A 组和 B 组 FPG，HbA1C，SCr，BUN 和24 h UKLB 明显高于 C 组（P ＜0．05）；TC，TG，LDL-C，AI，AIP 在 C 组、A组、B组间依次升高（P＜0．05）；但HDL-C和脂联素水平依次减低（P＜0．05）。B组经6个月干预治疗后，FPG，TC，TG，LDL-C， SCr，BUN，24 h UKLB、AI 及 AIP均较治疗前明显降低（P＜0．05），HDL-C、脂联素水平均明显升高（P＜0．05）；B 组治疗有效率为96．97％，不良反应发生率为22．73％。结论血清脂联素与糖尿病肾病动脉粥样硬化程度呈负相关，坎地沙坦联合阿托伐他汀治疗糖尿病肾病动脉粥样硬化，疗效可靠，能调节血脂水平，提高脂联素水平，改善动脉粥样硬化情况，安全性好，值得临床推广。