阿托伐他汀联合缬沙坦对早期糖尿病肾病患者尿微量白蛋白及炎性因子水平影响研究

Effect of Atorvastatin Combined with Valsartan on the Levels of Urinary Microalbumin and Inflammatory Factors in Patients with Early Diabetic Nephropathy

目的 观察阿托伐他汀联合缬沙坦对早期糖尿病肾病患者肾功能、尿微量蛋白及炎性因子的影响。方法选取2020年1月—2021年12月在大庆龙南医院内分泌科就诊的88例早期糖尿病肾病患者为研究对象,按随机数表法分为对照组和观察组,每组44例。对照组在常规治疗的基础上口服缬沙坦,观察组患者在对照组的基础上加用阿托伐他汀。对比两组患者的肾功能、炎性因子及激素水平。结果 治疗前,两组患者血清肌酸酐(SCr)、血尿素氮(BUN)、肾小球滤过率(GRF)、尿微量蛋白(mAlb)、β_(2)微球蛋白(β_(2)-MG)、24 h尿微量蛋白排泄率(UAER)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、超敏C-反应蛋白(hs-CRP)、胰岛素(FINS)、定量胰岛素敏感性检测指数(QUICKI)比较,差异无统计学意义(P>0.05);治疗后,两组患者BUN、SCr水平均处于正常范围内,差异无统计学意义(P>0.05),观察组的GFR、QUICKI均显著高于对照组,mAlb、β_(2)-MG、UAER、TNF-α、IL-6、hs-CRP、FINS均显著低于对照组,差异有统计学意义(P<0.05)。结论 阿托伐他汀联合缬沙坦可以有效改善早期糖尿病肾病患者的肾功能,控制炎性因子水平,提高胰岛素的敏感性,临床应用价值高。

Objective To observe the effect of atorvastatin combined with valsartan on renal function,urinary microprotein and inflammatory factors in patients with early diabetic nephropathy.Methods A total of 88 patients with early diabetic nephropathy who visited the Endocrinology Department of Daqing Longnan Hospital from January 2020 to December 2021 were selected as the research objects.According to random number method,they were divided into control group and observation group,with 44 cases in each group.The control group received oral valsartan on the basis of conventional treatment,and the observation group received atorvastatin on the basis of the control group.The renal function,inflammatory factors and hormone levels were compared between the two groups.Results Before treatment,serum creatinine(SCr),blood urea nitrogen(BUN),glomerular filtration rate(GRF),urine trace protein(mAlb),β_(2) microglobulin(β_(2)-MG),24 h urine trace protein excretion rate(UAER),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP),insulin(FINS),quantitative insulin sensitivity test index(QUICKI) comparison,the difference was not statistically significant(P>0.05);after treatment,the levels of BUN and SCr in the two groups were within the normal range,and the difference was not statistically significant(P>0.05),the GFR and QUICKI of the observation group were significantly higher than those of the control group,m Alb,β_(2)-MG,UAER,TNF-α,IL-6,hs-CRP and FINS were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion Atorvastatin combined with valsartan can effectively improve the renal function of patients with early diabetic nephropathy,control the level of inflammatory factors,improve the sensitivity of insulin,and has high clinical application value.