CAJ | 학술논문

目的：观察瑞舒伐他汀治疗2型糖尿病临床期肾病的疗效，探讨瑞舒伐他汀肾保护作用的机制。方法将62例2型糖尿病临床期肾病患者随机分为2组，对照组31例给予常规治疗，治疗组31例在常规治疗基础上加用瑞舒伐他汀10 mg/d，疗程8周。观察2组治疗前后血糖、血脂、肾功能、24 h尿蛋白定量（24hU-Pr）、血白蛋白（ ALB）和超敏C反应蛋白（hs-CRP）等指标的变化。结果治疗前2组血清总胆固醇（TC）、低密度脂蛋白胆固醇（ LDL-C）、高密度脂蛋白胆固醇（ HDL-C）、三酰甘油（ TG）、空腹血糖（ FBG）、糖化血红蛋白（HbA1c）、24hU-Pr、ALB、血清肌酐（SCr）、肾小球滤过率及hs-CRP比较差异均无统计学意义（P均＞0．05）；治疗后治疗组TC、LDL-C、TG、24hU-Pr、hs-CRP与对照组相比明显降低（P均＜0．01），HDL-C明显升高（P＜0．01），而FBG、HbA1c、ALB、SCr、肾小球滤过率比较差异无统计学意义（P均＞0.05）。结论瑞舒伐他汀在有效降脂的同时，可直接或间接抑制临床期糖尿病肾病患者hs-CRP的表达，减少患者24 h尿蛋白排泄，起到一定的肾脏保护作用。
목적：관찰서서벌타정치료2형당뇨병림상기신병적료효，탐토서서벌타정신보호작용적궤제。방법장62례2형당뇨병림상기신병환자수궤분위2조，대조조31례급여상규치료，치료조31례재상규치료기출상가용서서벌타정10 mg/d，료정8주。관찰2조치료전후혈당、혈지、신공능、24 h뇨단백정량（24hU-Pr）、혈백단백（ ALB）화초민C반응단백（hs-CRP）등지표적변화。결과치료전2조혈청총담고순（TC）、저밀도지단백담고순（ LDL-C）、고밀도지단백담고순（ HDL-C）、삼선감유（ TG）、공복혈당（ FBG）、당화혈홍단백（HbA1c）、24hU-Pr、ALB、혈청기항（SCr）、신소구려과솔급hs-CRP비교차이균무통계학의의（P균＞0．05）；치료후치료조TC、LDL-C、TG、24hU-Pr、hs-CRP여대조조상비명현강저（P균＜0．01），HDL-C명현승고（P＜0．01），이FBG、HbA1c、ALB、SCr、신소구려과솔비교차이무통계학의의（P균＞0.05）。결론서서벌타정재유효강지적동시，가직접혹간접억제림상기당뇨병신병환자hs-CRP적표체，감소환자24 h뇨단백배설，기도일정적신장보호작용。
Objective It is to observe the clinical efficacy of rosuvastatin on clinical-stage diabetic nephropathy and to ex-plore the mechanism of rosuvastatin in the renal protective effect .Methods 62 patients of clinical stage of diabetic nephropathy in type 2 diabetes mellitus were randomly divided into two groups:treatment group and control group .The control group of 31 cases were given conventional treatment , the treatment group of 31 cases were added with rosuvastatin 10mg/d on the basis of conventional therapy , the treatment courses were lasted for 8 weeks .The changes of blood glucose , blood lipid , renal func-tion, 24 h urinary protein, serum albumin and hs-CRP index were observed in both group before and after treatment .Results Before treatment , there was no significant difference in the levels of total cholesterol ( TC) ,low density lipoprotein ( LDL-C), high density lipoprotein(HDL-C), triglyceride(TG), fasting blood glucose (FBG), glycosylated hemoglobin A1c (HbA1c), 24 hour urinary protein quantitative (24 hU-Pr), serum albumin (ALB), serum creatinine (SCr), glomerular filtration rate (GFR) and hs-CRP between the two groups (P>0.05);after treatment, TC, LDL-C, TG, 24hU-Pr, hs-CRP decreased significantly compared with the control group (P<0.01), HDL-C significantly increased (P<0.01), but no statistical significant differences in FBG , HbA1c, ALB, SCr, GFR was found(P>0.05).Conclusion Rosuvastatin can effectively decrease blood lipid , at the same time, it also can inhibit expression of hs -CRP in patients with clinical stage dia-betic nephropathy directly or indirectly ,reduce urinary protein excretion of 24h, so as to play some protective effect of kidney .