CAJ | 학술논문

目的：：观察不同剂量辛伐他汀对老年早期糖尿病肾病患者炎症因子和肾功能的影响。方法：160例老年早期糖尿病肾病患者随机分为对照组、低剂量组、常规剂量组和大量组。各组均给予基础治疗,低剂量组、常规剂量组、大量组分别在基础治疗同时加用辛伐他汀10,20,40 mg·d-1。4周后观察比较各组患者治疗前后炎症因子( CRP、ICAM-1、IL-1β)和肾功能指标( BUN、Cr、UAER、24hUpro、Uβ2-MG)变化及药品不良反应。结果：治疗后大量组CRP水平较治疗前显著降低,且明显低于对照组治疗后(P<0.05)；治疗后低量组、常量组和大量组ICAM-1水平均较治疗前显著降低,且明显低于对照组治疗后(P<0.05)；治疗后4组IL-1β水平均无明显变化(P>0.05)。治疗后4组BUN水平均无明显变化(P>0.05)；Cr、UAER水平均较治疗前显著降低(P<0.05),且辛伐他汀各剂量组均低于对照组治疗后(P<0.05),常量组和大量组低于低量组(P<0.05)；治疗后辛伐他汀各剂量组24 h Upro、Uβ2-MG水平均较治疗前显著降低,且低于对照组治疗后(P<0.05)；且常量组和大量组Uβ2-MG水平低于低量组治疗后(P<0.05),大量组低于常量组治疗后(P<0.05)。四组不良反应发生率比较,差异无统计学意义(P>0.05)。结论：辛伐他汀治疗从炎症因子和肾功能指标两个方面可以改善糖尿病肾病的病情,大剂量辛伐他汀表现出一定的优势。
목적：：관찰불동제량신벌타정대노년조기당뇨병신병환자염증인자화신공능적영향。방법：160례노년조기당뇨병신병환자수궤분위대조조、저제량조、상규제량조화대량조。각조균급여기출치료,저제량조、상규제량조、대량조분별재기출치료동시가용신벌타정10,20,40 mg·d-1。4주후관찰비교각조환자치료전후염증인자( CRP、ICAM-1、IL-1β)화신공능지표( BUN、Cr、UAER、24hUpro、Uβ2-MG)변화급약품불량반응。결과：치료후대량조CRP수평교치료전현저강저,차명현저우대조조치료후(P<0.05)；치료후저량조、상량조화대량조ICAM-1수평균교치료전현저강저,차명현저우대조조치료후(P<0.05)；치료후4조IL-1β수평균무명현변화(P>0.05)。치료후4조BUN수평균무명현변화(P>0.05)；Cr、UAER수평균교치료전현저강저(P<0.05),차신벌타정각제량조균저우대조조치료후(P<0.05),상량조화대량조저우저량조(P<0.05)；치료후신벌타정각제량조24 h Upro、Uβ2-MG수평균교치료전현저강저,차저우대조조치료후(P<0.05)；차상량조화대량조Uβ2-MG수평저우저량조치료후(P<0.05),대량조저우상량조치료후(P<0.05)。사조불량반응발생솔비교,차이무통계학의의(P>0.05)。결론：신벌타정치료종염증인자화신공능지표량개방면가이개선당뇨병신병적병정,대제량신벌타정표현출일정적우세。
Objective:To observe the effect of simvastatin at different doses on the inflammatory factors and renal function in se-nile patients with diabetic kidney disease ( DKD) . Methods:Totally 160 cases of DKD patients were randomly divided into the control group, low dose group, conventional dose group and high dose group. All the patients were given the foundation treatment, and the low dose group, conventional dose group and high dose group was respectively given simvastatin 10, 20,40 mg·d-1 . The changes of in-flammatory cytokines (CRP, ICAM-1 and IL-1β) and renal index (BUN, Cr, UAER, 24hUpro and Uβ2-MG) among the groups were observed and compared before and after the 4-week treatment. Results:CRP in the high dose group after the treatment was significantly decreased when compared with that before the treatment and that in the control group after the treatment, and the difference was statisti-cally significant (P<0. 05). ICAM-1 in the low dose group, conventional dose group and high dose group was significantly decreased when compared with that before the treatment and that in the control group after the treatment, and the difference was statistically sig-nificant (P<0. 05). IL-1β in the four groups after the treatment had no obvious change when compared with that before the treatment, and there was no significant difference among the groups (P >0.05). BUN in the four groups after the treatment had no obvious change when compared with that before the treatment, and there was no significant difference among the groups (P>0. 05). Cr and UAER in the four groups after the treatment were significantly decreased (P<0. 05), those in the low dose group, conventional dose group and high dose group after the treatment were significantly lower than those in the control group after the treatment (P<0. 05), and those in the conventional dose group and high dose group after the treatment were significantly lower than those in the low dose group after the treatment (P<0. 05). 24hUpro in the low dose group, conventional dose group and high dose group after the treatment was significantly decreased when compared with that before the treatment and that in the control group after the treatment (P<0. 05). Uβ2-MG in the low dose group, conventional dose group and high dose group after the treatment was significantly decreased when com-pared with that before the treatment and that in the control group after the treatment (P<0. 05), that in the conventional dose group and high dose group after the treatment was significantly decreased when compared with that in the low dose group after the treatment (P<0. 05), and that in the high dose group after the treatment was significantly lower than that in the conventional dose group after the treatment (P<0. 05). ③There was no statistically significant difference in the adverse reactions incidence among the four groups (P>0. 05). Conclusion:Simvastatin can improve diabetic nephropathy conditions in two aspects of inflammation factors and renal in-dex, and simvastatin at high dose shows more advantages.