阿托伐他汀钙片对糖尿病肾病患者炎性因子、微循环障碍和血小板参数的影响

Effects of Combination of Atorvastatin on Inflammatory Factors,Microcirculatory Disturbances and Platelet Parameters in Patients with Diabetic Nephropathy

目的探讨阿托伐他汀钙片治疗对糖尿病肾病(diabetic nephropathy,DN)患者炎性因子、微循环障碍和血小板参数的影响。方法选取2016年1月—2018年6月收治的140例DN,根据治疗方法的不同,分为观察组与对照组,每组各70例。对照组予常规治疗,观察组在此基础上加用阿托伐他汀钙片。两组均治疗6个月。评估治疗后临床效果,检测治疗前后肾功能相关指标[血肌酐、血尿素、尿白蛋白/尿肌酐(ACR)]、炎性因子相关指标[超敏C反应蛋白(hs-CRP)、白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)]、微循环障碍相关指标[纤维蛋白原(Fib)、内皮素-1(ET-1)、全血低切黏度]、血小板参数[血小板(PLT)、血小板平均体积(MPV)]及血小板内皮细胞黏附分子-1(PECAM-1)的水平变化,记录治疗期间不良反应发生情况。结果观察组治疗后总有效率高于对照组,差异有统计学意义(P<0.05)。与对照组治疗后比较,观察组治疗后血尿素、ACR、hs-CRP、IL-1、TNF-α、Fib、ET-1、全血低切黏度、PLT、MPV及PECAM-1水平下降,差异有统计学意义(P<0.05或P<0.01);与本组治疗前比较,两组治疗后血尿素、ACR、hs-CRP、IL-1、TNF-α、Fib、ET-1、全血低切黏度、PLT、MPV及PECAM-1水平均降低,差异有统计学意义(P<0.01)。治疗期间,观察组未见明显不良反应;对照组出现低血糖1例,自行处理后缓解。结论阿托伐他汀钙片治疗DN的临床效果良好,可对患者炎症反应、微循环障碍及血小板参数产生积极影响。

Objective To explore the effects of combination of Atorvastatin on inflammatory factors,microcirculatory disturbances and platelet parameters in patients with diabetic nephropathy(DN).Methods A total of 140 patients with DN admitted between January 2016 and June 2018 were selected and divided into observation group(n=70)and control group(n=70)according to the different treatment methods.Control group was given conventional treatment,while observation group was supplemented with Atorvastatin on this basis,and the two groups were treated for 6 months.The clinical efficacy after treatment was evaluated.The renal function-related indexes[serum creatinine(SCr),blood urea nitrogen(BUN),urine albumin-creatinine ratio(ACR)],inflammatory factors-related indexes[high-sensitivity C-reactive protein(hs-CRP),interleukin-1(IL-1),tumor necrosis factor-α(TNF-α)],related indexes of microcirculatory disturbances[fibrinogen(Fib),endothelin-1(ET-1),whole blood low-shear viscosity],platelet parameters[platelet count(PLT),mean platelet volume(MPV)]and platelet endothelial cell adhesion molecule-1(PECAM-1)were detected before and after treatment.And the occurrence of adverse reactions during treatment was recorded.Results The total response rate of treatment in observation group was significantly higher than that in control group(P<0.05).Compared with control group after treatment,the levels of BUN,ACR,hs-CRP,IL-1,TNF-α,Fib,ET-1,whole blood low-shear viscosity,PLT,MPV and PECAM-1 were decreased in observation group after treatment(P<0.05 or P<0.01).Compared with those before treatment in this group,the levels of the above indicators were reduced in the two groups after treatment(P<0.01).During the treatment,there were no obvious adverse reactions in observation group,while there was 1 case of hypoglycemia in control group,which was relieved after treatment.Conclusion Combination of Atorvastatin has good clinical effects on DN,and has positive effects on the inflammatory response,microcirculatory disturbances and platelet parameters levels.