瑞舒伐他汀对肾小球硬化症患者动脉粥样硬化的影响

The effect of rosuvastatin on atherosclerotic status in patients with glomerulosclerosis

目的探讨瑞舒伐他汀对肾小球硬化症患者炎性反应介质和抗动脉粥样硬化的作用。方法选择38例肾小球硬化症患者,随机分为2组,观察组22例予瑞舒伐他汀10 mg口服,每天1次,对照组16例未接受任何调脂治疗,仍维持其原有治疗不变。治疗12个月后观测血脂水平、估计的肾小球滤过率(eGFR)、高敏C反应蛋白(hs-CRP)、血管内膜中层厚度(IMT)等检测指标的变化。结果观察组患者血清总TC、LDL-C、TG、尿蛋白、hs-CRP降低,最大血管IMT显著降低[由(1.89±0.98)mm降至(1.75±0.87)mm,P<0.05]、eGFR增加[由(50.7±18.7)增至(53.3±20.1)ml·min^(-1)·1.73 m^(-2),P<0.05],对照组无明显变化(P>0.05)。观察组eGFR、尿蛋白改善均优于对照组(P<0.05)。结论瑞舒伐他汀不仅有显著的血脂调节作用,还能降低患者血管内膜中层厚度以及改善炎性反应的作用。

Objective To investigate the efficacy of rosuvastatins on atherosclerotic status in patients with glomerulo- sclerosis. Methods Thirty-eight patients with glomerulosclerosis and LDL cholesterol levels 〉 2.6mmol/L were randomly as- signed to receive 10 mg/day rosuvastatin （observation group, n = 22） or without rosfiavastatin treatment （control group, n = 16）. Lipid profile, estimated glomerular filtration rate （eGFR）, high sensitivity C reactive protein （hs-CRP）, and intima media thickness （IMT） were measured before and 12 months after rosuvastatin was added to the treatment. Results Total cholesterol, 1ow density lipoprotein cholesterol, trig]ycerides, proteinuria and hs-CRP were significantly reduced in patients who received rosuvastatin treatment. These parameters remained unchanged in patients who did not treated with rosuvastatin. The IMT decreased from （1.89 ＋ 0.98 ）mm to （1.75 ＋ 0.87）mm after 12 months treatment （ P 〈 O. 05 ）, the eGFR was signifi- cantly increased from （50.7 ~ 18.7） mt ~ min-1 ~ 1.73 m-2 to （53.3 ~20.1 ） ml ~ rain-~ ~ 1.73 m-2 in observation group （ P 〈 0.01 ）, while no obviously changes in control group（ P 〉 0.05 ）. The improvemeI^t of eGFR and proteinuria in observa- tion group was superior to those in control group （ P 〈 0.05 ）. Conclusion It provided that the rosuvastatin had beneficial effect on cholesterol levels, in addition to reduce the maximal IMT and modified the inflammatory state.