阿托伐他汀对糖尿病肾病患者心血管事件及氧化应激反应和内皮损伤的影响

Effects of atorvastatin on cardiovascular events, oxidative stress and endothelial injury in patients with diabetic nephropathy

目的探讨糖尿病肾病患者应用阿托伐他汀的心血管获益情况。方法选择2012年5月—2014年12月期间就诊的96例糖尿病肾病患者,随机分为两组。对照组患者接受常规降糖治疗联合缬沙坦治疗,观察组患者在对照组基础上联用阿托伐他汀。随访两组12周内发生脑梗死和心肌梗死的例数,测定治疗前后的血清超氧化物歧化酶(SOD)、丙二醛(MDA)内皮素-1(ET-1)、一氧化氮(NO)含量,同时对比不良反应发生率。结果观察组患者治疗后的血清SOD和NO含量显著高于治疗前,MDA和ET-1含量显著低于治疗前(P<0.05),且与对照组比较差异有统计学意义(P<0.05);治疗过程中观察组患者心血管事件发生率低于对照组(2.08%vs.25.00%,χ~2=10.766,P<0.05);两组患者恶心、呕吐、食欲不振等并发症发生率差异无统计学意义(P>0.05)。结论阿托伐他汀对糖尿病肾病患者的心血管事件具有预防价值,可能与减轻氧化应激反应和内皮损伤有关。

Objective To investigate the cardiovascular benefit of atorvastatin for diabetic nephropathy patients. Methods Totally 96 diabetic nephropathy patients during May 2012 to December 2014 were selected and randomly divided into two groups. Patients in the control group received conventional hypoglycemic therapy combined with valsartan treatment, and patients in the observation group received conventional hypoglycemic therapy combined with valsartan and atorvastatin therapy. The incidence of cerebral infarction and myocardial infarction were followed up for 12 weeks. Serum superoxide dismutase(SOD),malondialdehyde(MDA), endothelin-1(ET-1), nitric oxide(NO) levels were measured before and after treatment, and the incidence of adverse reactions was compared. Results After treatment, serum SOD and NO levels in the observation group were significantly higher than those before treatment, MDA and ET-1 levels were significantly lower than those before treatment(all P<0.05), and there were significant differences between the observation group and the control group(all P<0.05). The incidence of myocardial infarction and cerebral infarction in the observation group was significantly lower than that in the control group(2.08% vs. 25.00%)(χ2=10.766, P<0.05); however, there was no significant difference in the incidence of complication such as nausea, vomiting and loss of appetite between the two groups(P>0.05). Conclusion Atorvastatin can prevent cardiovascular events in patients with diabetic nephropathy and reduce oxidative stress, endothelial damage.