替米沙坦联合阿托伐他汀对糖尿病肾病患者血管内皮功能及微炎症状态的影响  

The effect of telmisartan combined with atorvastatin on vascular endothelial function and micro-inflammatory state in the patients with diabetic nephropathy

作　　者：蒋霄翔 潘荣荣[1] JIANG Xiaoxiang;PAN Rongrong(Department of Internal Medicine,the People′s Hospital of Cixi City in Zhejiang Province,Cixi315300,China)

机构地区：[1]浙江省慈溪市人民医院内科,浙江慈溪315300

出　　处：《中国现代医生》2021年第15期42-45,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2020KY290)。

摘　　要：目的探讨替米沙坦联合阿托伐他汀对糖尿病肾病的患者血管内皮功能及微炎症状态的影响。方法选取2019年1—6月门诊治疗DN患者92例,随机分为联用组和对照组,每组各46例。两组予严格饮食控制、适当体育锻炼及药物控制血糖等基础治疗。联用组加替米沙坦(80 mg/次,1次/d,口服)联合阿托伐他汀(10 mg/次,1次/d,口服)治疗,对照组予单用替米沙坦片治疗,其剂量、方法与联用组相同。两组连用12周,观察两组治疗前后血管内皮功能指标[内皮素-1(ET-1)和一氧化氮(NO)]和微炎症状态[血清超敏C反应蛋白(hs-CRP)和肿瘤坏死因子-α(TNF-α)]水平的变化,并比较临床效果。结果治疗12周后,两组血清ET-1水平较治疗前明显下降,NO水平较治疗前明显上升(P<0.05或P<0.01),且联用组变化幅度较对照组更显著(P<0.05);两组血清hs-CRP和TNF-α水平较治疗前明显下降(P<0.05或P<0.01),联用组下降幅度较对照组更显著(P<0.05);治疗12周后,联用组临床总有效率为95.65%,明显高于对照组的82.61%,差异有统计学意义(χ^(2)=4.040,P<0.05)。结论替米沙坦联合阿托伐他汀治疗DN患者的疗效较确切,不仅能明显降低血清ET-1水平,升高血清NO水平,改善血管内皮功能,而且可降低血清hs-CRP和TNF-α水平,改善微炎症状态。Objective To explore the effect of telmisartan combined with atorvastatin on vascular endothelial function(VEF)and micro-inflammatory state in the patients with diabetic nephropathy(DN).Methods A total of 92 patients with DN treated in the outpatient service from January to June 2019 were selected and randomly divided into the combination group and the control group,with 46 patients in each group.The two groups were given basic treatments such as strict diet control,appropriate physical exercise and drug use in the control of blood glucose,etc.The combination group was administered telmisartan(80 mg,qd,oral)combined with atorvastatin(10 mg,qd,oral),while the control group was administered telmisartan tablets alone,with the same dosage and method as the combination group.The treatment for each of the two groups lasted 12 weeks.The changes of the indexes of VEF[endothelin-1(ET-1)and nitric oxide(NO)]and the levels of micro-inflammatory state[serum high sensitivity C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α)]in the two groups before and after treatment were observed,and the clinical effects were compared.Results After 12 weeks of treatment,the levels of serum ET-1 in the two groups decreased more significantly than that before treatment,while the levels of NO increased more significantly than that before treatment(P<0.05 or P<0.01),and the changes in the combination group were more significant than that in the control group(P<0.05).The levels of serum hs-CRP and TNF-αin the two groups decreased more significantly than that before treatment(P<0.05 or P<0.01),and the decrease in the combination group was more significant than that in the control group(P<0.05).Meanwhile,the total clinical effective rate in the combination group was 95.65%,which was higher than that of 82.61%in the control group,with significant difference(χ^(2)=4.040,P<0.05).Conclusion The therapy of telmisartan combined with atorvastatin has a definite curative effect on the patients with DN.It can not only decrease the level of s

关 键 词：糖尿病肾病 替米沙坦 阿托伐他汀 血管内皮功能 微炎症状态 

分 类 号：R654.2[医药卫生—外科学]