阿托伐他汀治疗老年慢性肾病伴高脂血症患者的效果

Effect of Atorvastatin on elderly patients with chronic kidney diseases complicated with hyperlipidemia

目的探讨选用阿托伐他汀治疗慢性肾病伴高脂血症老年患者降低炎性因子、改善患者生活质量的效果。方法2016年3月至2017年3月人院接受药物治疗的肾病伴高脂血症患者中抽取100例按随机数字法分组，对照组行传统处理（抗凝、饮食控制、标准激素应用等），观察组加用阿托伐他汀，对比两组致炎因子、血脂指标改善及总疗效情况。结果2组控脂总有效率分别为76．00（38／50）、94．00（47／50），观察组高于对照组（x^2=6．352，P〈0．05）；治疗后，观察组总胆固醇、三酰甘油、低密度脂蛋白胆固醇（LDL—C）、高密度脂蛋白胆固醇（HDL—C）改善程度优于对照组（t=71．804、10．544、15．266、3．499，P〈0．05）；经治疗，观察组肿瘤坏死因子（TNF—α）为（1．1士0．2）μg／L，尿蛋白定量为（1．1±0．7）g／24h，C反应蛋白（CRP）为（8．2±0．1）mg／L，相比对照组均更低（t=12．695、6．101、39．898，均P〈0．05）。结论将阿托伐他汀应用于肾病伴高脂血症老年患者治疗，控脂、炎症抑制效果理想，使患者生活质量明显改善。

Objective To investigate the effects of Atorvastatin on reducing the levels of inflammatory factors and on improving the quality of life in elderly patients with chronic kidney disease complicated with hyperlipidemia. Methods One hundred patients with chronic kidney disease accompanied with hyperlipidemia were enrolled from March 2016 to March 2017,and randomized into two groups： a control group undergoing conventional treatment with anticoagulant, diet control and standard glucocortieosteroid, and an observation group receiving Atorvastatin as add on therapy to conventional treatment. Improvements of serum levels of inflammatory factors and blood lipid indices as well as total curative effect were compared between the two groups. Results The total effective rate was significantly higher in the observation group[94.0%（47/50）] than in the control group （76.0% ,38/50）（x^2 = 6. 352 ,P〈0.05）. After treatment,the improvements of blood lipid indices（TC, TG,LDL-C, HDL-C）were more in the observation group than in the control group（t =71. 804, 10. 544,15. 266,3. 499,all P〈0.05）. Before treatment,the serum levels of TNF-alpha,CRP and the 24h urine protein had no statistically significant differences between control and observation groups（P =0. 406 or 0. 678, respectively）, but the levels in post-vs, pre-treatment were statistically significant lower in TNF-alpha[（1.1±0.2）vs. （1.8±0.3）μg/L ],CRP[（8.2±0.1）vs. （9.3±0.1） mg/L]and 24h urine protein[（1, 1±0.7）vs. （2.3±1.1）g/24 h] （all P〈0.05）. Conclusions Atorvastatin as add-on treatment to conventional therapy of chronic kidney diseases complicated with hyperlipidemia in the elderly has significant effects on controlling dyslipidemia and reducing inflammatory reactions so as to improve patients＇ quality of life.