阿托伐他汀对早期糖尿病肾病患者血清胱抑素C及尿微量蛋白的影响

Effect of atorvastatin on serum cystatin C and urinary micro-protein in patients with earlydi abetic nephropathy

目的探讨阿托伐他汀对早期糖尿病肾病（DN）患者血清胱抑素C及尿微量蛋白的影响。方法68例早期DN患者按照随机数字表法分为对照组和观察组，每组34例，对照组予常规治疗，观察组在常规治疗基础上予阿托伐他汀治疗，比较两组治疗前后血脂、血清胱抑素C、尿白蛋白排泄率（UAER）、尿微量蛋白[微量白蛋白（MAU）、α1微球蛋白（α1-MG）、β2微球蛋白（β2-MG）]的变化。结果观察组治疗后总胆固醇（TC）、三酰甘油（TG）、血清胱抑素C、UAER、MAU、α-MG、BrMG较治疗前均显著下降[（4．32±1．26）mmol／L比（5．65±1．38）mmol／L，（1．67±0．64）mmol／L比（2．53±0．96）mmol／L，（1．294±0．38）mg／L比（1．74±0．51）mg／L，（61．09±18．45）μg／min比（86．42±21．34）μg]min，（5．73±4．81）mg／L比（23．16±9．73）mg／L，（1．41±1．21）mg／L比（4．76±1．24）mg／L，（1．21±0．13）mg／L比（2．58±0．26）mg／L]（P〈0．0l或〈0．05）；对照组治疗后Tc、TG、血清胱抑素C较治疗前有所下降，但差异无统计学意义（P〉0．05），而UAER、MAU、MAU、α1-MG、β2-MG与治疗前比较差异有统计学意义（P〈0．0l或〈0．05），但下降程度不及观察组（P〈0．05或〈0．01）。结论阿托伐他汀可显著降低早期DN患者血清胱抑素C及尿微量蛋白水平，起到肾脏保护作用。

Objective To study the effect of atorvastatin on serum cystatin C and urinary microprotein in patients with early diabetic nephropathy （DN）. Methods Sixty-eight cases of early DN were divided into control group and observation group with 34 cases each by random digits table, the control group was treated with the conventional treatment, the observation group was treated with atorvastatin on the basis of conventional treatment, then blood lipids, serum cystatin C, urinary albumin excretion rate （UAER）, microalbuminuria（MAU）, α1 rmicroglobnlin（MG）, β2-MG between the two groups were compared. Results After intervention, the levels of total cholesterol （TC）, triacylglycerol （TG）, serum cystatin C, UAER, MAU, α1-MG, β2-MG were significantly decreased compared with those before treatment in the observation group [ （4.32 ± 1.26） mmol/L vs. （5.65 ± 1.38 ） mmol/L, （ 1.67± 0.64） mmol/L vs. （2.53 ± 0.96） mmol/L, （ 1.29 ± 0.38 ） mg/L vs. （ 1.74 ± 0.51 ）mg/L, （ 61.09 ± 18.45 ） μg/min vs. （ 86.42 ±21.34 ） μg/min, （ 5.73 ± 4.81） mg/L vs.（23.16±9.73） mg/L, （1.41 ± 1.21） mg/L vs.（4.76 ± 1.24） mg/L, （1.21±0.13） mg/L vs. （2.58 ± 0.26） mg/L]（P〈 0.01 or 〈 0.05）. In the control group, the levels ofTC, TG, serum cystatin C were lower than those before treatment, but there were no significant differences （P 〉 0.05）, but the levels of UAER, MAU, α1-MG, β2-MG had significant differences compared with those before treatment （P 〈 0.0l or 〈 0.05 ） and the same time of the observation group （P 〈 0.05 or 〈 0.01 ）. Conclusion Atorvastatin cansignificantly reduce serum cystatin C and urinary micro-protein levels in patients with early DN, which plays an important role in kidney protection.