阿托伐他汀对糖尿病肾病患者脂蛋白（a）和纤溶酶原激活抑制物-1的影响

The effect of atorvastatin on sermn level of Hpoprotein（a） and plasminogen activator inhibitor-1 on patients with diabetic nephropathy

目的探讨阿托伐他汀对糖尿病肾病（DN）患者脂蛋白（a）[Lp（a）]、组织纤溶酶原激活物（tPA）以及纤溶酶原激活抑制物-1（PAI-1）的影响。方法60例DN患者随机分为2组，治疗组患者给予阿托伐他汀20mg每日1次睡前服用，对照组给予安慰剂，共6周，治疗前后所有患者测定血糖、肾功能、总胆固醇（TC）、甘油三脂（TG）、高密度脂蛋白-C（HDL-C）、低密度脂蛋白-C（LDL-C）、PAI-1、tPA以及尿白蛋白排泄率（UAER）进行比较。结果6周后，治疗组与对照组相比，TC、TG、LDL-C、Lp（a）、PAI-1活性及UAER下降（P〈0．05或P〈0．01），而HDLC水平和tPA活性上升（P〈0．05）。对照组治疗前后各项指标无明显变化（P〉0．05），而治疗组治疗前后上述指标有显著改变（P〈0．05或P〈0．01）。结论阿托伐他汀在降低DN患者血脂的同时，通过降低Lp（a）改善纤溶系统功能，保护受损的肾脏功能。

Objective To study the effect of atorvastatin on serum levels of lipoprotein（a） and plasminogen activator inhibitor on the patients with diabetic nephropathy. Method 60 patients with diabetic nephropathy were randomly divided into treatment group treated with atorvastatin（20 mg/d） and a control group. The changes of serum levels of total cholesterol（TC）, triglyeride（TG）, high density lipoprotein-C（HDL-C）, low density lipoprotein-C（LDL-C）, fasting blood glucose（FBG）, serum creatinine（Scr）, lipoprotein（a）[Lp（a）], urinary albumin excretion rate（UAER）, the activity of tissue-type plasminogen（tPA） activator and its inihibitor-1 （PAI-1） were observed before and 6 weeks after treatment. Results After 6 weeks, the levels of serum TC, TG, Lp（α）, the activity of PAI-I and UAER were lower in treatment group than those in control group（P〈0. 05 or P〈0. 01）. The level of serum HDL-C and the activity of PAI-1 raised in the treatment group（P〈0. 05）. The parameters mentioned above were not varied before and after 6 weeks in the control group（P〉0. 05）. Conclusions Atorvastatin can play an important role in protecting renal function through improving the fibrinolytic function by regulating blood lipids especially lowing Lp （a） for the patients of diabetic nephropathy.