氟伐他汀对2型糖尿病患者尿微量白蛋白的影响

Effects of Fluvastatin on microalbuminuria of type 2 diabetes mellitus patients

目的探讨氟伐他汀降低2型糖尿病患者尿白蛋白排泄率（UAER）的临床效果。方法将合并微量白蛋白尿的2型糖尿病早期肾病患者随机分为氟伐他汀组126例和对照组129例，氟伐他汀组每晚加服氟伐他汀40mg，对照组不服氟伐他汀。平均随访1．5年。比较2组治疗前后的尿白蛋白排泄率、血脂及肾小球滤过率。结果氟伐他汀组治疗前后尿蛋白排泄率为（59．6±10．5）mg／min和（104，4±25．2）mg／min，P〈0．05），对照组为（87．5±12．3）mg／min和（110．6±19．7）mg／min，P〈0、05），尿白蛋白排泄率均较治疗前明显下降；氟伐他汀组UAER下降较对照组更明显（P〈0．05），且独立于调脂作用。2组肾小球滤过率比较差异无统计学意义[（75．8±10．6）ml／min·m^2。和（76．3±8，4）ml／min·m^2，P〉0．05）]。结论氟伐他汀能减少合并早期肾病的2型糖尿病患者尿白蛋白排泄率且独立于其调脂效应，廷缓糖尿病肾病的进展。

Objective To observe the effect of fluvastatin on urinary albumin excretion rate （UAER） of microalbuminuria in type 2 diabetes patients. Methods Type 2 diabetes patients with microalbuminuria were randomly divided into fluvastatin group （ n = 126 ） and control goup （ n = 129 ）. Fluvastatin group was given fluvastatin 40 mg each night. Follow up was conducted for 1.5 years. The UAER and glomerular filtration rate （GFR） as well as blood lipid level before and after therapy were compared. Results UAER in fluvastatin group was significantly lower than that in control group [ （ 59.6 ± 10.5 ） vs （ 87.5 ± 12.3 ） mg/min, P 〈 0. 05 ] before therapy [ （ 104.4 ± 25.2 ） vs （ 110.6 ± 19.7 ） rag/rain, P 〈 0. 05 ] , which was independent of its lowering-lipid effect. But GFR had no significant difference [ （75.8 ± 10.6） vs （76.3 ± 8.4 ） ml/min · m^2,P 〉 0.05 ） ]. Conclusion Fluvastatin can decrease microalbuminuria which is independent of lowering-lipid effect in type 2 diabetic nephropathy patients and delay the progress of diabetic nephropathy.