罗伐他汀对血液透析患者微炎症状态及血脂的影响

The effect of rosuvastatin on micro-inflammatory and serum lipids in hemodialysis patients

目的探讨罗伐他汀对血液透析患者微炎症状态及血脂的影响。方法选取2014年4月至2016年4月间入院行血液透析的100例患者,随机分为对照组与治疗组,对照组接受常规血液透析,治疗组在对照组基础上口服罗伐他汀,40 mg,1次/d,比较两组一般资料、微炎症指标、血脂及临床症状。结果对照组与治疗组的年龄、性别、透析龄、体质量、原发病、超滤量、MQSGA评分、血尿素氮(BUN)、血肌酐(Scr)、总胆固醇(TC)、三酰甘油(TG)等指标进行对比,差异无统计学意义;治疗前两组血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、TC、低密度脂蛋白(LDL)、TG、血尿酸(BUA)差异均无显著性;在治疗后3个月,治疗组CRP、IL-6、TNF-α、TG、LDL、TC及BUA均显著低于对照组(P<0.05);血液透析治疗中,对照组与治疗组出现乏力为4例vs.0例(8%vs.0%,P=0.04),疲劳症状为7例vs.1例(14%vs.2%,P=0.02),肌肉痉挛为8例vs.2例(16%vs.4%,P=0.04),低血压为5例vs.0例(4%vs.2%,P=0.02),治疗组显著低于对照组。结论罗伐他汀可明显改善血液透析患者微炎症状态,降低血脂,改善透析相关临床症状。

Objective To investigate the effect of Rosuvastatin on micro-inflammatory and serum lipids in hemodialysis patients.Method A total of 100 hemodialysis patients enrolled in our hospital from April 2014 to April 2016 was divided into control and treatment group.The control group received regular hemodialysis.The treatment group received regular hemodialysis combined with rosuvastatin.The general information,micro inflammatory index,serum lipids and clinical symptoms were compared between the two groups.There was no significant difference between the two groups in terms of age,sexual,time of hemodialysis,primary disease,ultrafiltration volume,MQSGA score,BUN,Scr,TC and TG.There was no significant difference between these two groups in terms of CRP,IL-6,TNF-α,TC,LDL,TG before the treatment.The treatment group was significantly lower than that of control group,in terms of CRP,IL-6,TNF-α,TG,LDL,TC and BUA,after treatment.In the 3-month treatment,50 patients in control and treatment group appears weakness：4 vs.0（8%vs.0%,P=0.041）;fatigue symptom：7 vs.1（14%vs.2%,P=0.027）;muscle spasm：8 vs.2（16%vs.4%,P=0.045）;hypotension：5 vs.0（4%vs.2%,P=0.021）.Treatment group was remarkably lower than control group（P〈0.05）.Conclusion Rosuvastatin can effectively alleviate the micro-inflammatory state of remission,reduce serum lipid and uric acid in hemodialysis patients,and improve the complications in hemodialysis.