氟伐他汀对2型糖尿病肾病患者CTGF及TGF-β_1的作用及临床意义  

Effects of Fluvastatin on Serum Levels of CTGF and TGF-β_1 in Patients with Type 2 Diabetic Kidney Disease and Its Clinical Significance

作　　者：王丽晖[1] 刘青娟[2] 吴广礼[1] 杨新军[1] 林静[1] 黄旭东[1] WANG Li-hui;LIU Qing-juan;WU Guang-li;YANG Xin-jun;LIN Jing;HUANG Xu-dong(Department of Nephrology,Bethune International Peace Hospital of PLA,Shijiazhuang 050082,China;Department of Pathology,Hebei Medical University,Shijiazhuang 050017,China)

机构地区：[1]解放军白求恩国际和平医院肾脏病科,石家庄050082 [2]河北医科大学病理教研室,石家庄050017

出　　处：《临床误诊误治》2018年第9期18-22,共5页Clinical Misdiagnosis & Mistherapy

基　　金：河北省自然基金资助项目(302500)

摘　　要：目的观察氟伐他汀对2型糖尿病肾病(diabetic kidney disease,DKD)患者血清结缔组织生长因子(connective tissue growth factor,CTGF)和转化生长因子-β_1(transforming growth factor-beta 1,TGF-β_1)表达水平的影响,探讨他汀类药物的肾脏保护作用及机制。方法选择我院收治的伴或不伴血脂异常的DKD80例,随机分为观察组和对照组,每组各40例。两组均予常规治疗,在此基础上,观察组加用氟伐他汀20 mg/d,均治疗16周。比较两组治疗前后血尿素(BUN)、肌酐(Cr)、β_2-微球蛋白(β_2-MG)、空腹血糖(FBS)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、尿白蛋白排泄率(UAER)及血清TGF-β_1、CTGF的水平变化。结果与本组治疗前比较,观察组治疗后UREA、TC、TGF-β_1、CTGF水平下降,差异有统计学意义(P<0.01);与对照组比较,观察组治疗后UREA、TC、TGF-β_1、CTGF水平明显降低,差异有统计学意义(P<0.01)。结论氟伐他汀可降低DKD患者UAER,同时在有效降脂时显著降低TGF-β_1和CTGF血清水平。Objective To observe the effect of fluvastatin on the serum level of connective tissue growth factor （CTGF） and transforming growth factor-beta 1（TGF-β 1 ） in patients with type 2 diabetic kidney disease （DKD）, in order to investigate the protective effect of fluvastatin on the kidneys and its mechanism. Methods A total of 80 patients with type 2 DKD with or without dyslipidemia were randomly divided into two groups： observation group （ n = 40） and control group （ n =40）. Both groups were given conventional treatment. The patients of observation group were given fluvastatin （20 mg/d） for 16 weeks on the basis of conventional treatment.The changes in blood urea nitrogen （BUN）, creatinine （Cr）, β 2-microglobin （β 2-MG）, fasting blood sugar （FBS）, glycosylated hemoglobin （HbA1c）, serum total cholesterol （TC）, and triglycerides （TG）, high-density lipoprotein （HDL-C）, low-density lipoprotein （LDL-C）, urinary albumin excretion rate （UAER）, serum TGF-β 1 and CTGF were recorded and compared before treatment and 16 weeks after treatment. Results Compared with those before treatment and those in control group, the serum levels of UAER, TC, TGF-β 1 and CTGF were significantly decreased in observation group, suggesting significant differences （ P 〈0.01）. Conclusion Fluvastatin can decrease UAER and lipids in patients with DKD, and significantly reduce serum levels of TGF-β 1 and CTGF in the meantime.

关 键 词：糖尿病肾病 转化生长因子Β1 结缔组织生长因子 

分 类 号：R587.24[医药卫生—内分泌]