辛伐他汀对糖尿病肾脏病微炎症状态的影响

Effects of simvastatin in treating of diabetic kidney disease patients

目的观察糖尿病肾脏病（DKD）微炎症状态及辛伐他汀对微炎症状态的影响。方法选择2010年1月至2010年12月在我科住院并长期随访的DKD患者60例，根据。肾小球滤过率（GFR）水平，将所有患者分为3组，其中慢性肾脏病（CKD）3期组19例，CKD4期组23例，CKD5期组18例。同时从我科医护人员中选取20名健康志愿者为正常对照组。对CKD3、4、5期组患者给予辛伐他汀口服，每次40mg，每晚1次，连用8周。分别在治疗前、后测定患者血清白细胞介素（IL）-6、C反应蛋白（CRP）、铁蛋白、三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白（LDL）等。并测定正常对照组IL-6、CRP、铁蛋白等微炎症指标。结果与正常对照组相比，CKD3、4、5期组治疗前IL-6、CRP较高（P〈0．05），CKD5期组铁蛋白较高（P〈0．05）。治疗后，CKD3、4、5期组IL-6、CRP、铁蛋白较治疗前降低（P〈0．05），CKD4、5期组LDL降低（P〈0．05），CKD3期组LDL及各组TG、TC治疗前、后差异无统计学意义（P〉0．05）。结论辛伐他汀能够改善DKD患者的微炎症状态，其改善与血脂的下降无明显相关性。

Objective To observe the microinflammation state of diabetic kidney disease pa- tients, and investigate the therapeutic efficacy of simvastatin in microinflammation of diabetic kidney disease patients. Methods A total of 60 diabetic kidney disease patients were divided into CKD 3 stage group （n = 19）, CKD 4 stage group （n = 23） and CKD 5 stage group （n = 18）. All of the diabet- ic patients received oral simvastatin in a dosage of 40 mg/day for 8 weeks. Before and after treatment, the changes of microinflammation indicators and adverse reactions were observed. The microinflammation indicators were compared among CKD 3-5 stage groups and normal group before treatment. Results IL-6 and CRP levels in CKD 3-5 stage groups were significantly increased, and serum ferritin levels were increased in CKD 5 stage group before treatment as compared with normal group （P〈0. 05）. After treatment with simvastatin, IL-6, CRP and ferritin levels were reduced in CKD 3-5 stage groups, and LDL levels were decreased in CKD 4-5 stage groups as compared with those before treat- ment （P〈0. 05）. There was no statistically significant difference in LDL in CKD 3 stage group, and TG and TC levels in all groups between and after treatment （P〉0. 05）. Conclusions Simvastatin can manage microinflammation state in diabetic kidney disease patients effectively, and there is no relevant relation with the decrease in serum lipid level.