阿托伐他汀对血脂正常的老年早期糖尿病肾病尿蛋白及相关因素的影响

The effect of atorvastatin on urine protein and correlation factor in older patients with early diabetic nephropathy without hyperlipemia

目的探讨阿托伐他汀对血脂正常老年患者早期糖尿病肾病（DN）尿蛋白、内皮素（ET）、一氧化氮（NO）、C反应蛋白（CRP）的影响。方法血脂正常的50例2型糖尿病老年患者，随机分为常规用药组（常规组）25例；在常规组基础上加用阿托伐他汀组（联合组）25例，另设健康老年人为对照组25例。测定治疗前后血脂（CH、TG、LDL、HDL）、ET、NO、CRP、尿白蛋白排泄率（UAER）。结果DN患者血ET、CRP显著高于对照组，NO明显低于对照组。常规组治疗12周后与治疗前比较血脂、ET、NO、CRP、UAER差异无显著性，联合组治疗后CH、TG、LDL、ET、CRP、尿UAER显著降低，NO、HDL明显升高。结论阿托伐他汀可改善ET、NO失衡，改善血脂水平，减轻炎症反应，减少早期糖尿病肾病患者的尿微量白蛋白，有保护肾脏的作用。

Objective To study the effect of atorvastatin on urine protein （UAER）, endothelin （ET）, nitrogen monoxidum （NO）, C -Reactive protein （CRP） in older patients with early diabetic nephropathy （DN） without hyperlipemia. Methods Fifty older DN without hyperlipemia were randomly divided into two groups, the conventional treatment group （n = 25 ）, conventional treatment plus atorvastatin group （ unitive group, n = 25 ）, and 25 normal controls were chosen as normal control. The plasma serum lipids （CH ,TG, LDL, HDL）, ET, NO, CRP and urinary al- bumin excretion rate（UAER） were examined before and after the treatment. Results The levels of ET, CRP in patients with DN was higher than those in normal control group, and the level of NO was lower. After 12 weeks of treatment,the levels of serum lipids, ET, NO and UAER had no changes in the conventional treatment group, but they were improved in unitive group. Conclusion Atorvastatin can decrease the levels of UAER in older patients with early diabetic nephropathy ,which may be due to its correction of abnomal renal hemodynamies through decreasing ET and increasing NO, improving serum lipids, lessening inflammatory reaction.