瑞舒伐他汀与阿托伐他汀对维持性血液透析患者血脂及微炎症状态的影响比较

Effects of rosuvastatin and atorvastatin on blood lipid and microinflammation in patients with maintenance hemodialysis: a comparative study

目的比较瑞舒伐他汀与阿托伐他汀对维持性血液透析患者血脂及微炎症状态的影响。方法选取2014年5月至2016年12月于我院行维持性血液透析治疗患者106例为本研究试验对象,按随机数字表法分为A、B组,每组各53例。在常规治疗基础上,A组接受瑞舒伐他汀片10 mg/d,B组接受阿托伐他汀钙片,20 mg/d,均12周。记录患者治疗前后的血脂指标及营养学指标。结果治疗前2组患者在血脂、微炎症状态及营养学指标上差异无统计学意义(P>0.05),但接受12周治疗后2组患者在治疗后的血脂指标上,总胆固醇(TC)、甘油三酯(TG)及高密度脂蛋白胆固醇(HDL-C)水平差异无统计学意义,但A组低密度脂蛋白胆固醇(LDL-C)水平低于B组[(2.1±0.6)mmol/L与(2.8±0.7)mmol/L)],且差异具有统计学意义(P=0.03)。A组治疗后的微炎症状态参数水平显著低于B组,其中超敏C反应蛋白(hs-CRP)水平为(2.5±0.4)mg/L与(3.3±0.6)mg/L(P=0.03)。另外,在治疗后A组的各营养学指标水平显著高于B组,其中血清白蛋白(ALB)水平为(32±4)g/L与(30±6)g/L(P=0.04)。结论与阿托伐他汀相比,瑞舒伐他汀改善维持性血液透析患者的血脂、微炎症状态及营养不良的临床效果更佳。

Objective To investigate and compare the effects of rosuvastatin and atorvastatin on the blood lipid and microinflammation in patients with maintenance hemodialysis. Methods A total of 106 patients, who underwent maintenance hemodialysis in our hospital between May 2014 and December 2016, were included as the subjects in the study, and randomly divided into groups A and B (n=53 each). On the basis of conventional treatment, group A received 10 mg/d rosuvastatin and group B received 20 mg/d atorvastatin for continuous 12 weeks. The levels of blood lipid parameters and microinflammation parameters;and nutritional parameters were recorded before and after the treatment. Results There were no significant differences in the blood lipid, microinflammation and nutritional parameters between the two groups at the baseline (P>0.05), whereas the parameters in each group were improved significantly at 12 weeks after the treatment. In the blood lipid parameters after the treatmnet, there were no significant differences in the levels of TC, TG and HDL-C between the two groups. The LDL-C level in group A was lower than that in group B [(2.1±0.6)mmol/L vs (2.8±0.7)mmol/L], with statistically significantly difference (P=0.03). The levels of microinflammation parameters in group A were significantly lower than those in group B after the treatment, such as the hs-CRP level[(2.5±0.4)mg/L vs (3.3±0.6)mg/L, P=0.03]. Additionally, the levels of nutritional parameters in group a were significantly higher than those in group B after the treatment, such as the ALB level [(32±4)g/L vs.(30±6)g/L,P=0.04]. Conclusion Compared with atorvastatin, rosuvastatin shows better clinical effects in improving blood lipid, microinflammation and malnutrition in patients with maintenance hemodialysis.