摘要
目的:探讨2型糖尿病血清脂蛋白(a)水平变化对肾功能的影响以及降低脂蛋白(a)水平在防治早期糖尿病肾病(DN)进展中的意义。方法:(1)根据尿白蛋白排泄率(UAER)测定结果将132例糖尿病患者分为单纯DM组(56例)和早期DN组76例,比较上述两组和正常对照组(56例)的脂蛋白(a)水平;(2)将76例早期DN患者随机分为两组,对照组(30例)予常规治疗,治疗组(46例)在常规治疗基础上每晚服用阿托伐他汀20mg。分别于治疗前和治疗后6周末检测脂蛋白(a)、FBG、UAER和血肌酐,分析脂蛋白(a)水平变化与早期DN进展之间的关系。结果:(1)单纯DM组脂蛋白(a)水平与正常对照组比较无显著性差异(P>0.05),早期DN组血清脂蛋白(a)水平明显高于正常对照组和单纯DM组(P<0.01),脂蛋白(a)水平与UAER呈直线正相关(P<0.01)。(2)治疗组血清脂蛋白(a)水平显著降低(P<0.01),且随着脂蛋白(a)水平的下降,UAER和血肌酐亦同步下降。结论:血清脂蛋白(a)水平升高与DN进展有关,降低血清脂蛋白(a)水平能有效减少早期DN患者的尿蛋白排泄,延缓肾功能减退。
Objective: To investigate the effect on renal function of different levels of lipoprotein(a), and the relationship between lipoprotein(a) levels and progression of early diabetic nephropathy(EDN ) and the significance of lowering of serum Lp(a) in preventing progression of EDN in type 2 diabetics. Methods: Serum Lp (a) concentration was measured and compared between non--diabetic controls and type 2 diabetes mellitus patients including 56 patients without DN [urinary albumin excretion rate (UAER)〈30 mg/24h, group DM] and 76 with microalbuminuria(UAER 30-300 mg/ 24h,group EDN). Seventy-six patients with EDN were randomly divided into control group (n=30) and treatment group (n=46) which was treated with 20 microgram of oral atorvastatin every night in addition to routine therapy. All patients were followed up for 6 weeks. Lp (a), FBG, UARE and Scr in both groups were compared 6 weeks before and after the treatment. Results: Lp(a) levds were similar between DM group and non-diabetic contruls(P〉0.05 ). But in the group of EDN, Lp(a) was significantly higher than those of the former two groups(P〈0.01 ). There was a positive correlation between Lp(a) concentration and UAER(r=0.7466,P〈0.01 ). Lp(a) significantly decreased in the treatment group(P〈0.01 ),accompanied by decrease in UAER and Set. Conclusion: Increased serum Lp(a) may be associated with the progression of EDN. Lowering serum Lp(a) can ameliorate microalbuminuria and postpone the occurrence of renal function failure in patients with type 2 diabets.
出处
《大理学院学报(综合版)》
CAS
2007年第4期17-19,共3页
Journal of Dali University
关键词
脂蛋白(a)
糖尿病肾病
尿白蛋白排泄率
阿托伐他汀
lipoprotein(a)
diabetic nephrupathy
urinary albumin excretion rate
atorvastatin(ATO)