阿托伐他汀对糖尿病肾病患者血清肿瘤坏死因子-α的影响

Effect of Atorvastatin on Serum TNF-α in Patients with Diabetic Nephropathy

【目的】通过观察阿托伐他汀对糖尿病肾病（DN）患者血清肿瘤坏死因子-α（TNF-α）的影响，探讨阿托伐他汀对肾脏的保护作用。【方法】将75例DN患者随机分为不同剂量治疗组（A组、B组）和对照组（C组），每组25例。C组给予常规西药治疗，A组在C组基础上加用阿托伐他汀20mg／d，B组则40mg／d。用酶联免疫吸附法（Elisa）测定三组患者治疗前后血清TNF-α的含量变化，同时观察空腹血糖（FBG）、血肌酐（SCr）、尿素氮（BUN）、总胆固醇（TC）、甘油三脂（TG）的变化。【结果】A、B组患者治疗后血清TNF-α、FBG、SCR、BUN及TC、TG水平均下降，与本组治疗前比较差异有统计学意义（P〈0．05或P〈0．01）；A、B组TNFld、SCR、BUN及TC、TG均低于C组（P〈0．05或P〈0．01），且B组TNF-α、SCR及BUN优于A组（P〈0．05）。【结论】阿托伐他汀不但能降低DN患者的血脂水平。而且可能通过降低血清TNF—α的含量，达到对DN的肾脏保护作用。

[ObjectivelTo observe the effect of atorvastatin on serum tumor necrosis facto-alpha（TNF-α） in patients with diabetic nephropathy（DN）, and to explore the protective effect of atorvastatin on the kidney. [MethodslSeventy five DN patients were randomly divided into treatment group（group A, group B） and control group（group C） with 25 cases in each. Group C was treated with routine western medicine. Based on the remedy of group C, group A and group B were additionally treated with atorvastatin 20mg/d and 40rag/d, re spectively. The levels of serum TNF-α in three groups were determined by enzyme linked immunosorbent assay （ELISA） before and after treatment. Meanwhile, the change of fasting blood glucose（FBG）, serum creatinine （Scr）, urea nitrogen（BUN）, total cholesterol（TC） and triglyceride（TG） were observed. [Results] Serum lev els of TNF-α, FBG,Scr, BUN, TC and TG in group A and B after treatment declined, and there were significant differences between before and after treatment（ P〈0.05 or P d0.01）. The levels of TNF-α, Scr, BUN, TC and TG in group A and B were less than those in group C（ P d0.05 or P〈i0.01）. Moreover, TNF-α, Scr and BUN in group B were superior to group A（ P〈0. 05）. [Conclusion] Atorvastatin can not only reduce blood fat, but also protect the kidney through decreasing serum TNF-α in DN patients.