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瑞舒伐他汀对血脂正常的早期糖尿病肾病患者疗效及内皮功能的影响

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摘要:

目的 观察瑞舒伐他汀治疗血脂正常的早期糖尿病肾病(DN)患者的疗效及对内皮功能的
影响。方法 选择2019年1月至2020年6月于焦作市疾病预防控制中心收治的90例DN患者,随机分为对照
组和观察组,每组各45例,对照组予以常规治疗,观察组在对照组基础上加用瑞舒伐他汀钙片,6个月为
1疗程。比较两组患者的临床疗效,检测肾功能[尿素氮(BUN)、血清肌酐(Scr)、血清胱抑素C(Cyst
C)、24 h尿白蛋白排泄率(UAER)],血脂[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇
(LDL-C)、高密度脂蛋白胆固醇(HDL-C)],血管内皮功能[静息状态下肱动脉内径基础值(D),血
流介导的肱动脉血管内径舒张(FMD)及含服0.5 mg硝酸甘油后肱动脉血管内径舒张(NID)]和内皮功
能相关因子[一氧化氮(NO)、内皮素(ET)和血管内皮生长因子(VEGF)]含量,记录不良反应。结果
治疗后,与对照组相比,观察组BUN、Scr、Cyst C、UAER及血浆ET含量较低,FMD和血浆NO含量较高
(P<0.05)。观察组总有效率为88.4%,显著高于对照组的72.7%(P<0.05)。两组不良反应发生率无统
计学差异。结论 瑞舒伐他汀治疗血脂正常的早期DN患者安全有效,同时可保护血管内皮功能。

Abstract:

Objective To observe the influence of rosuvastatin on curative effect and endothelial function in patients with early diabetic nephropathy (DN) and normal blood fat. Methods DN patients (n=90) were chosen from Disease Prevention and Control Center of Jiaozuo City from Jan. 2019 to June 2020, and randomly divided into control group and observation group (each n=45). The control group was given routine treatment and observation group was additionally given rosuvastatin for 6 months (one treatment course). The clinical efficacy was compared between 2 groups. The indexes of kidney function [blood urea nitrogen (BUN), serum creatinine (SCr), serum cystatin C (Cys C), 24-h urinary albumin excretion rate (UAER)], blood fat [total cholesterol (TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C)], vascular endothelial function [basal value of brachial artery diameter in resting state (D), brachial artery flow-mediated dilation (FMD), nitroglycerin-induced dilatation (NID) of brachial artery after sublingual nitroglycerin (0.5 mg)], and correlators of endothelial function [nitric oxide (NO), endothelin (ET), vascular endothelial growth factor (VEGF)] were detected, and adverse reactions were recorded in 2 groups. Results The levels of BUN, Scr, Cyst C,UAER and plasma ET were lower, and levels of FMD and NO were higher in observation group than those in control group (P<0.05). The total effective rate was 88.4% in observation group and 72.7% in control group (P<0.05). The incidence rates of adverse reactions had no statistical difference between 2 groups. Conclusion Rosuvastatin is safe and effective and can protect endothelial function in patients with early DN and normal blood fat.

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