氟伐他汀对老年动脉粥样硬化所致肾动脉狭窄的临床疗效观察

Curative Effects of Fluvatin on Atherosclerotic Renal Artery Stenosis

目的观察氟伐他汀对老年肾动脉粥样硬化所致肾动脉狭窄(ARAS)的治疗作用及其抗炎机制。方法将在我院门诊及住院的54例老年ARAS患者,随机分为治疗组及对照组,对照组给予常规降压治疗,治疗组每晚加服氟伐他汀40 mg。比较两组治疗前及治疗后尿蛋白排泄率(UAER)、血肌酐(Scr)、C反应蛋白(CRP)及肾脏血管多普勒超声中肾动脉收缩期峰值速度(PSV)、肾动脉血流加速度时间(AT),肾动脉峰值流速与肾动脉开口处腹主动脉流速之比(RAR)等指标。结果观察期间,两组上述指标均呈下降趋势,治疗组UAER,PSV,AT,RAR下降较对照组明显(P<0.05,P<0.01),治疗组CRP下降明显(P<0.05,P<0.01),对照组CRP变化不明显(P>0.05)。而且在两组血脂正常的老年ARAS所致肾动脉狭窄的患者进行比较分析也得出类似结果。结论氟伐他汀因降低CRP的致炎效应而改善肾动脉狭窄,且不依赖氟伐他汀的降血脂作用。

Objective To investigate the curative effects of fluvastin on atherosclerotic renal artery stenosis （ARAS） and its antiinflammation mechanism. Methods A total of 54 patients with ARAS were divided into two groups at random, i.e. control group（ n = 27 ） and treatment group （ n= 27 ）. The control group received conventional therapy, while the treatment group was given oral fluvastin （40 microgram） every night. Then, their UA excretion rate （UAER） , serum creatinine （Scr） and C-reaction protein （CRP） were measured three, six and nine months later, respectively, as well as PSV, AT and RAR. Results Factors such UAER, Scr, PSV, AT and BAR decreased more significantly and quickly in the treatment group than in the control group （ P 〈 0.05, on P 〈0.01 ）. CRP decreased significantty in the treatment group, while no significant decrease was found in the control group according to nine months follow-up. Furthermore, similar results were also obtained in those with ARAS with normal blood lipid level when further analysis was done. Conclusion Fluvastin can meliorate microalbuminuria and inprove renal function by its anti-inllammation effect via decreasing CRP, which is independent of its lowering lipid effect.