阿托伐他汀在2型糖尿病肾病中的应用效果及对肾纤维化指标的影响

Application Effect of Atorvastatin in Type 2 Diabetic Nephropathy and Its Influence on Renal Fibrosis Indexes

目的探讨阿托伐他汀在2型糖尿病肾病(T2DN)中的应用效果及对肾纤维化指标的影响。方法78例研究对象均为2020年7月—2021年6月期间于该院就诊的T2DN患者,以随机数表法分为两组,每组各纳入39例患者。两组采取常规饮食管理、合理运动、降糖等措施。对照组口服硝苯地平缓释片、替米沙坦、螺内酯治疗,在此基础上研究组口服阿托伐他汀钙片治疗。针对两组治疗效果、干预前后血糖水平与肾纤维化指标[金属蛋白酶组织抑制因子-1(TIMP-1)、胱抑素C(CysC)、Ⅳ型胶原(CⅣ)、转化生长因子-β(TGF-β)],以及不良反应进行比较。结果在治疗的总有效率比较中,研究组结果为94.87%较对照组76.92%高,差异有统计学意义(χ^(2)=5.186,P<0.05)。治疗后,研究组餐后2 h血糖、空腹血糖指标较对照组低,差异有统计学意义(t=5.190、4.763,P<0.05)。治疗后,研究组TIMP-1、CⅣ、TGF-β、CysC指标较对照组低,差异有统计学意义(t=22.667、12.215、7.471、6.925,P<0.05)。在不良反应对比中,两组均为7.69%,差异无统计学意义(χ^(2)=0.181,P>0.05)。结论阿托伐他汀在T2DN患者中具有显著的应用效果,能够有效改善肾纤维化指标,安全性佳,值得在临床推广。

Objective To investigate the application effect of atorvastatin in type 2 diabetic nephropathy(T2DN)and its influence on renal fibrosis indexes.Methods Seventy-eight subjects were all T2DN patients who visited the hospital from July 2020 to June 2021.They were divided into two groups by random number table,with 39 patients in each.The two groups took routine diet management,reasonable exercise,hypoglycemic and other measures.The control group was treated with nifedipine sustained-release tablets,telmisartan,and spironolactone,and the study group was treated with atorvastatin calcium tablets.The treatment effect,blood glucose level and renal fibrosis indexes before and after intervention in the two groups(tissue inhibitor of metalloproteinase-1(TIMP-1),cystatin C(CysC),type IV collagen(CIV),transforming growth factor-β(TGF-β)],and adverse reactions were compared.Results In the comparison of the total effective rate of treatment,the result of the study group was 94.87%higher than that of the control group 76.92%,the difference was statistically significant(χ^(2)=5.186,P<0.05).After treatment,the 2 h postprandial blood glucose and fasting blood glucose in the study group were lower than those in the control group,the difference was statistically significant(t=5.190,4.763,P<0.05).After treatment,the indexes of TIMP-1,CIV,TGF-βand CysC in the study group were lower than those in the control group,the difference was statistically significant(t=22.667,12.215,7.471,6.925,P<0.05).In the comparison of adverse reactions,both groups were 7.69%,and the difference was not statistically significant(χ^(2)=0.181,P>0.05).Conclusion Atorvastatin has a significant application effect in patients with T2DN,can effectively improve renal fibrosis indicators,has good safety,and is worthy of clinical promotion.