阿托伐他汀对维持性血液透析患者炎症因子的影响

Effect of Different Doses of Atorvastatin on Cytokines and Blood Pressure During Maintenance Hemodialysis in Patients with Chronic Renal Failure

目的:探讨不同剂量阿托伐他汀对维持性血液透析(maintenance hemod iabysisMHD)患者炎症因子的影响。方法:选择维持性血液透析的尿毒症患者65例,随机分为10mg组与20mg组,在常规治疗基础上,每晚分别口服阿托伐他汀10mg和20mg,在治疗前、治疗1个月、治疗3个月时观察血清炎症指标:可溶性细胞间黏附分子-1(sICAM-1)、白介素6(IL-6)、血清高敏反应C蛋白(hs-CRP)浓度及血压、血脂、血压、营养指标。结果:两组患者治疗1、3个月后血清IL-6、hs-CRP、sICAM-1水平较治疗前明显降低(P<0.05),其中20mg组较10mg组降低更明显(P<0.01);两组治疗1个月时,收缩压及舒张压均有降低但无统计学意义(P>0.05),3个月后血压较治疗前明显降低(P<0.05),但两组比较无统计学意义。两组治疗1、3个月后TC、TG、LDL-C均较治疗前明显降低(P<0.05),3个月后20mg组TC、LDL-C较10mg组明显降低(P<0.05);两组治疗3个月后白蛋白浓度均较治疗前明显增高(P<0.05)。结论:常规服用阿托伐他汀可改善维持性血液透析患者的微炎症状态及脂代谢紊乱。

Objective： To investigate the effects of different doses of atorvastatin on serum levels of interlerkin-6 （ IL-6）, hypersensitive C reactive protein （hs-CRP） and soluble intercellular adhesion molecule 1 （ sICAM-1 ） and blood pressure on chronic renal failure during maintenance hemodialysis （ MHD ）. Methods： Sixty-five patients with chronic renal failure during MHD were randomly divided into 10 mg atorvastatin group （n = 35） and 20 mg atovastatin group （n = 30）. Both were administered once daily for 12 weeks in addition to a routine therapy. Serum levels of IL-6, hs-CRP, sICAM-1 ,TG,TC, LDL-C, HB, BUN, CRE and blood pressure were measured before and in 1 and 3 months after treatment. ELISA method was used to measure IL-6 and sICAM-1 and Radioimmunoassay was used to measure hs-CRP. Results： The serum levels of IL- 6,hs-CRP and sICAM-1 were significantly decreased in 1 and 3 months after treatment in both groups compare to those before treatment （ P 〈 0.05 ） , especially in the 20mg atorvastatin group（ P 〈 0.01 ）. The blood pressure was lowered without significant difference in 1 month （ P 〉 0.05 ） but with statistical difference in 3 months in both groups compared to that before treatment （ P 〈 0.05 ） and no difference was noted between the 2 groups. TC ,TG and LDL-C was reduced in 1 and 3 months （ P 〈 0.05 ） and more reduction of TC and LDL-C was found in the 20mg group in 3 months （ P 〈 0.05 ）. The serum levels of albumin and HB were significantly increased in both groups （P 〈 0.05 ）. Conclusion：Atorvastatin intervention may improve the micro-inflammatory state and lipid metabolic disorder in patients during MHD.