瑞舒伐他汀联合缬沙坦治疗糖尿病肾病临床研究

Clinical Study on Rosuvastatin Combined with Valsartan in the Treatment of Patients with Diabetic Nephropathy

目的探讨瑞舒伐他汀联合缬沙坦对糖尿病肾病患者血脂、24 h尿微量白蛋白排泄率(UAER)、超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)及肾功能的影响。方法选取医院2014年2月至2017年2月收治的糖尿病肾病患者126例,随机分为治疗组和对照组,各63例。对照组患者在常规治疗基础上给予缬沙坦,治疗组患者在对照组治疗基础上加用瑞舒伐他汀。两组患者均连续治疗6个月。结果治疗后,两组患者空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(Hb A1C)均较治疗前明显下降(P <0. 05),但组间比较无显著差异(P> 0. 05);治疗组患者总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)均明显改善(P <0. 05),而对照组患者无明显变化(P> 0. 05);两组患者的24 h UAER、血清胱抑素C(CysC)、视黄醇结合蛋白(RBP)、hs-CRP、IL-6、肿瘤坏死因子-α(TNF-α)、白细胞介素18(IL-18)水平均较治疗前明显下降(P <0. 05),且治疗组下降水平更显著(P <0. 05);两组患者治疗前后尿素氮(BUN)和肌酐(Cr)比较无明显差异(P> 0. 05);两组不良反应发生情况比较无明显差异(P> 0. 05)。结论瑞舒伐他汀联合缬沙坦治疗糖尿病肾病能有效调节患者的血脂,降低24 h UAER和炎性因子水平,保护肾功能,值得临床推广。

Objective To investigate the effect of rosuvastatin combined with valsartan on blood lipid,24 h UAER,hs-CRP,IL-6 and renal function in patients with diabetic nephropathy( DN). Methods Totally 126 patients with DN admitted to our hospital from February2014 to February 2017 were selected and randomly divided into the treatment group and the control group,63 cases in each group. The control group was given valsartan on the basis of routine treatment. The treatment group was given rosuvastatin on the basis of the control group. The two groups were treated for 6 months. Results After treatment,the levels of FBG,2 h PG and HbA1 Cin the two groups were significantly decreased than those before treatment( P < 0. 05),but there was no significant difference between the two groups after treatment( P > 0. 05). The levels of TC,TG,LDL-C and HDL-C in the treatment group were significantly improved( P < 0. 05),while there was no significant change in the control group( P > 0. 05). The levels of 24 h UAER,CysC,RBP,hs-CRP,IL-6,TNF-α and IL-18 in the two groups were significantly decreased than those before treatment( P < 0. 05),and the decrease in the treatment group was more significant( P < 0. 05). There was no significant difference in the levels of BUN and CR between the two groups before and after treatment( P > 0. 05),and there was no significant difference in the incidence of adverse reactions between the two groups( P > 0. 05). Conclusion Rosuvastatin combined with valsartan can effectively regulate the levels of blood lipids,reduce 24 h UAER and inflammatory factors in patients with DN,and protect renal function,which is worthy of clinical promotion.