瑞舒伐他汀对早期糖尿病肾病患者血清C反应蛋白和炎性细胞因子IL-1、IL-6表达的影响

The effects of rosuvastatin on the serum level of hs CRP,IL-1,IL-6 in the patients with the early-stage diabetic nephropathy

目的通过观察瑞舒伐他汀对2型糖尿病早期肾病患者血清高敏C反应蛋白(hs-CRP)和炎性细胞因子IL-1、IL-6表达水平的影响,探讨他汀类药物的肾保护作用及其机制。方法 60例伴或不伴血脂异常的2型糖尿病早期肾病患者,分为他汀组和常规组,并以30例健康体检者为对照组。他汀组在常规治疗基础上加用瑞舒伐他汀10mg/d,疗程12周。比较三组患者血糖、血脂、肾功、hs-CRP、24h尿微量白蛋白排泄率(UAER)及血清IL-1、IL-6。结果与对照组相比,他汀组和常规组24hUAER和hs-CRP显著升高(P<0.05),血清IL-1、IL-6显著升高(t=2.756,2.831,P<0.05);治疗前他汀组和常规组患者血清总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、甘油三酯(TG)、空腹血糖(FBS)、UAER及hs-CRP差异无统计学意义(P>0.05);治疗后常规组患者TC、LDL-C、TG水平无显著下降(t=0.844,0.906,1.987;P>0.05),他汀组患者TC、LDL-C、TG水平显著低于治疗前(t=2.944,2.731,2.678;P<0.05);治疗后两组患者UAER和hs-CRP水平均显著下降[t=2.906,2.725(常规组)和3.231,3.876(他汀组);P<0.05],但他汀组下降程度更为明显,与常规组治疗后相比差异有统计学意义(P<0.05)。结论瑞舒伐他汀可显著降低糖尿病肾病患者尿微量白蛋白排泄,在有效降脂的同时,可显著降低早期糖尿病肾病患者过高的血清hs-CRP水平,降低血清炎性介质IL-1、IL-6水平,这提示他汀类可通过抑制炎症过程减少尿蛋白,保护肾功能。

Objective To observe the effect of rosuvastatin calcium on the serum level of hs CRP,IL-1,IL-6 in the patients with the early-stage diabetic nephropathy,in order to investigate the protection effect and its mechanism.Methods 60 patients of type 2 early diabetics nephropathy were randomly divided into two groups:rosuvastatin calcium group and regular group.The patients were given 10 mg rosuvastatin calcium besides the conventional treatment for 12 weeks were in rosurastatin calcium group.30 healthy people were regarded as control group.The glucose,lipid,creatinine,urea nitrogen,C-reactive protein,24 h urinary micro-albumin and the serum level of IL-1,IL-6 were measured.Results Compared to the patients in control group,the serum level of TC,LDL C,TG,FBS,PBS,HDL C,UAER and hs CRP increased significantly(P<0.05),the serum level of IL-1,IL-6 also increased significantly(t=2.756,2.831,P<0.05).There were no significant differences in the serum level of TC,LDL C,HDL C,TG,FBS,PBS,UAER and hs CRP between two diabetic groups before treatment(P>0.05).After treatment,the serum level of TC,LDL C,TG showed no decrease in the patient in regular group(t=0.844,0.906,1.987;P>0.05),but significantly decreased in rosuvastatin calcium group(t=2.944,2.731,2.678;P<0.05).The serum level of hs CRP and 24h UAER decreased significantly in two diabetic groups[t=2.906,2.725(regular group)and 3.231,3.876(rousuvastatin calcium group),P<0.05] after treatment,and the serum level of IL-1,IL-6 also decreased significantly,especially in rosuvastatin calcium group(P<0.05).Conclusions Besides decrease the level of serum lipid,rosuvastatin can significantly reduce the microalbuminuria excretion and decrease the high serum level of hs CRP and inflammatory mediators such as IL-1,IL-6,these indicate that statins can reduce urine proteinby inhibiting the inflammatory process.