瑞舒伐他汀对早期糖尿病肾病患者肾脏保护作用观察

The clinical observation of the role of rosuvastatin in the treatment of early -stage diabetic nephropathy

目的：观察瑞舒伐他汀对早期糖尿病肾病患者的肾脏保护作用。方法将64例早期糖尿病肾病患者按数字表法随机分为治疗组和对照组各32例。对照组患者给予降血糖和降血压等常规治疗。治疗组在对照组常规治疗的基础上给予瑞舒伐他汀10 mg／d，每晚口服，两组疗程均为12周。分别于治疗前和治疗12周后，检测两组患者的尿微量白蛋白排泄率（UAER）、尿β2微球蛋白（β2-MG）、血肌酐（Scr）、C 反应蛋白（CRP）、空腹血糖（FPG）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）。结果治疗12周后，治疗组 UAER、Scr、β2-MG、CRP 均显著下降[（123．4±10．5）μg／min 比（85．4±12．6）μg／min，（98．2±11．5）μmol／L 比（76．3±8．6）μmol／L，（0．76±0．35）mg／L 比（0．37±0．21）mg／L，（19．5±1．5）mg／L 比（10．3±1．6）mg／L]，与治疗前比较差异均有统计学意义（t ＝3．461、3．532、3．284、3．671，均 P ＜0．05）。治疗后对照组与治疗组 UAER、Scr、β2-MG、CRP[（117±12．5）μg／min 比（85．4±12．6）μg／min，（92．7±8．3）μmol／L 比（76．3±8．6）μmol／L，（0．69±0．24）mg／L 比（0．37±0．21）mg／L，（17．7±1．2）mg／L 比（10．3±1．6）mg／L]比较差异均有统计学意义（t ＝3．365、3．584、3．752、3．274，均 P ＜0．05）。LDL-C、TC、TG 也均显著下降。结论瑞舒伐他汀在早期糖尿病肾病治疗中发挥调脂作用的同时，能抑制炎性反应，减少尿蛋白排泄，改善肾功能。

Objective To observe the protective effect of rosuvastatin on kidney in patients with early -stage diabetic nephropathy.Methods 64 patients with early -stage diabetic nephropathy were randomly divided into the treatment group（n =32）and the control group（n =32）.The patients of the treatment group were treated with rosuv-astatin （10mg,po,qn） ＋routine medication,while the patients of the control group were treated with routine medica-tion alone.All patients were treated for 12 weeks.Routine medication included diabetic diet,blood glucose control and anti -hypertensive drugs.Urinary albumin excretion rate （UAER）,urinary β2 -microglobulin （β2 -MG）,serum creatinine （Scr）,C -reactive protein（CRP）,fasting plasma glucose（FPG）,low density lipoprotein -C（LDL -C）, high density lipoprotein -C（HDL -C）,total cholesterol（TC）and triglyceride （TG）were determined and compared between the two groups before and after treatment for 12 weeks.Results 12 weeks after treatment,the levels of UAER,Scr,β2 -MG and CRP were lower in the treatment group compared with before treatment[（123.4 ±10.5）μg/min vs.（85.4 ±12.6）μg/min,（98.2 ±11.5）μmol/L vs.（76.3 ±8.6）μmol/L,（0.76 ±0.35）mg/L vs.（0.37 ± 0.21）mg/L,（19.5 ±1.5）mg/L vs.（10.3 ±1.6）mg/L],the differences were statistically significant（t =3.461, 3.532,3.284,3.671,all P 〈0.05）.12 weeks after treatment,the levels of UAER,Scr,β2 -MG and CRP in the con-trol group and in the treatment group were （117 ±12.5）μg/min vs.（85.4 ±12.6）μg/min,（92.7 ±8.3）μmol/L vs.（76.3 ±8.6）μmol/L,（0.69 ±0.24）mg/L vs.（0.37 ±0.21）mg/L,（17.7 ±1.2）mg/L vs.（10.3 ±1.6）mg/L,there were significant differences between the two groups （t =3.365,3.584,3.752,3.274,all P 〈0.05 ）. LDL -C,TC and TG were lower in the treatment group.Conclusion Rosuvastatin can improve renal function in patients with early -stage diabetic nephropathy by regulating the levels of blood lipid and decreasing the levels of CRP,UAER and urine protein.