氟伐他汀对早期糖尿病肾病患者Hcy、APN、MMP-9和mAlb的影响

摘要

Objective To investigate the effects of fluvastatin on urine microalbuminuria (mAlb), homocys-teine (Hcy), adiponectin (APN), matrix metalloproteinase-9 (MMP-9) in patients with early diabetic nephropathy (DN). Methods Fifty-eight patients with early diabetic nephropathy were randomly allocated to fluvastatin group of 30 cases and low-protein diet group of 28 cases. The fluvastatin group was treated by low-protein diet plus fluvastatin, while the low-protein diet group was treated with low-protein diet only, with the treatment course of 8 weeks. Fif-ty-five people with normal blood sugar were enrolled as control group. The levels of mAlb, Hcy, APN, MMP-9 were detected before and after treatment. Results The levels of mAlb, Hcy, MMP-9 before treatment in fluvastatin group and low-protein diet group were significantly higher than those in the control group (P<0.01), while the levels of APN in fluvastatin group and low-protein diet group were significantly lower than those in the control group (P<0.01), with no significant differences in the levels of ALT (P>0.05). Compared with that before treatment, the level of mAlb de-creased significantly in low-protein diet group after treatment (P<0.01), and the levels of Hcy, APN and MMP-9 showed no significant differences after treatment (P>0.05). In fluvastatin group, compared with that before treatment, the levels of mAlb, Hcy, MMP-9 all decreased significantly after treatment, and the level of APN increased significant-ly after treatment (P<0.01). Conclusion Hcy, APN, MMP-9 are closely correlated with diabetic nephropathy. Fluvas-tatin could decrease the levels of Hcy, MMP-9, mAlb and increase the level of APN.%目的：观察氟伐他汀对早期糖尿病肾病(DN)患者尿微量白蛋白(mAlb)、同型半胱氨酸(Hcy)、脂联素(APN)、基质金属蛋白酶-9(MMP-9)的影响。方法58例早期糖尿病肾病患者随机分为氟伐他汀组30例和饮食治疗组28例，两组患者疗程均为8周，同时选取55例血糖正常人群作为对照组，分别检测对照组和早期DN组患者治疗前后的mAlb、Hcy、APN、MMP-9、ALT水平，并对检测结果进行统计学分析。结果氟伐他汀组、饮食治疗组治疗前的mAlb、Hcy、MMP-9水平均显著高于对照组，APN水平显著低于对照组，差异均有显著统计学意义(P<0.01)，而ALT水平比较则差异无统计学意义(P>0.05)；饮食治疗组治疗后mAlb水平与治疗前比较显著下降(P<0.01)，而Hcy、APN、MMP-9水平变化不明显(P>0.05)；氟伐他汀组治疗后Hcy、MMP-9、mAlb水平与治疗前比较均显著下降，APN水平显著升高，差异均有显著统计学意义(P<0.01)。结论 Hcy、APN、MMP-9水平与糖尿病肾病密切相关，氟伐他汀有降低Hcy、MMP-9、mAlb及升高APN的作用。