阿托伐他汀辅助治疗对高血压肾病患者肾功能和血管内皮功能的影响  

Effects of Atorvastatin Adjuvant Therapy on Renal Function and Vascular Endothelial Function of Patients with Hypertensive Nephropathy

作　　者：程小丽[1] 杨世峰[2] 师锁江[1] 黄楠[1] CHENG Xiao-li;YANG Shi-feng;SHI Suo-jiang;HUANG Nan(Department of Nephrology,Ankang Central Hospital,Ankang,Shaanxi 725000,China;Department of Nephrology,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]安康市中心医院肾内科,陕西安康725000 [2]西安交通大学第一附属医院肾内科,西安710061

出　　处：《解放军医药杂志》2020年第3期100-104,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：西安交通大学第一附属医院青年科学创新基金(2016QN-30)。

摘　　要：目的研究阿托伐他汀辅助治疗对高血压肾病患者肾功能和血管内皮功能的影响。方法选取2016年5月—2017年8月收治的86例高血压肾病患者,按治疗方法不同分为阿托伐他汀组和常规治疗组,每组43例。常规治疗组进行常规降血压、降血脂治疗,阿托伐他汀组在常规治疗组基础上给予阿托伐他汀钙片治疗,2组疗程均为8周。观察2组治疗前后的血压、血脂、肾功能及血管内皮功能指标的变化情况,并记录治疗过程中出现的不良反应情况。结果2组治疗后的降血压效果比较差异无统计学意义(P>0.05)。治疗后,2组甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、血肌酐(Scr)、尿素氮(BUN)、24 h尿蛋白定量(TP/24 h)、尿微量白蛋白(mAlb)、尿β2微球蛋白(β2-MG)、颈动脉内-中膜厚度(IMT)、内皮素-1(ET-1)水平均低于治疗前,高密度脂蛋白胆固醇(HDL-C)、肱动脉内皮依赖性舒张功能(FMD)、一氧化氮(NO)水平均高于治疗前(P<0.05)。阿托伐他汀组治疗后TG、TC、LDL-C、Scr、BUN、TP/24 h、尿mAlb、尿β2-MG、IMT和ET-1水平均显著低于常规治疗组,而HDL-C、FMD和NO水平显著高于常规治疗组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论阿托伐他汀辅助降血压治疗可以有效改善高血压肾病患者的血脂水平,保护肾功能,并改善血管内皮功能。Objective To study the effects of Atorvastatin adjuvant therapy on renal function and vascular endothelial function of patients with hypertensive nephropathy.Methods Eighty-six patients with hypertensive nephropathy who were admitted from May 2016 to August 2017 were enrolled.They were divided into Atorvastatin group(n=43)and conventional treatment group(n=43)by different treatment methods.The conventional treatment group was treated with conventional antihypertensive and lipid-lowering therapy,and the Atorvastatin group was treated with Atorvastatin Calcium tablets on the basis of the conventional treatment group.The course of treatment in both groups was 8 weeks.The changes of blood pressure,blood lipids,renal function and vascular endothelial function before and after treatment in the two groups were observed.The adverse reactions during treatment period were recorded.Results There was no significant difference in hypotensive effect between the two groups(P>0.05).After treatment,triacylglycerol(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),serum creatinine(Scr),urea nitrogen(BUN),24 h urine protein quantitation(TP/24 h),urinary microalbumin(mAlb),urineβ2 microglobulin(β2-MG),intima-media thickness(IMT)and endothelin-1(ET-1)were significantly lower than those before treatment,while the levels of high-density lipoprotein cholesterol(HDL-C),flow mediated dilatation(FMD)and nitric oxide(NO)were significantly higher than those before treatment(P<0.05).After treatment,the levels of TG,TC,LDL-C,Scr,BUN,TP/24 h,urinary mAlb,urinaryβ2-MG,IMT and ET-1 in Atorvastatin group were significantly lower than those in the conventional treatment group,while the levels of HDL-C,FMD and NO were significantly higher than those in the conventional treatment group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Atorvastatin-assisted hypotensive therapy can effectively improve blood lipid levels,protect renal function,and improve vas

关 键 词：高血压肾病 阿托伐他汀 血尿素氮 肌酐 蛋白尿 血管内皮功能 

分 类 号：R544.1[医药卫生—心血管疾病] R692[医药卫生—内科学]