阿托伐他汀对腹膜透析患者血脂代谢及残余肾功能的影响  

Clinical trial of atorvastatin on lipid metabolism and residual renal function in peritoneal dialysis patients

作　　者：刘天君 张鹏 魏世远 LIU Tian-jun;ZHANG Peng;WEI Shi-yuan(Department of Nephrology,Yankuang New Journey General Hospital,Zoucheng 273500,Shandong Province,China)

机构地区：[1]兖矿新里程总医院肾内科,山东邹城273500

出　　处：《中国临床药理学杂志》2021年第16期2145-2147,2151,共4页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察阿托伐他汀对腹膜透析(peritoneal dialysis,PD)患者血脂代谢及残余肾功能的影响。方法将50例腹膜透析患者随机分为试验组和对照组,各25例。对照组进行降脂、抗炎等常规治疗;试验组在对照组的基础上给予阿托伐他汀治疗,起始剂量为20 mg·d^(-1),口服,28 d后根据患者病情情况逐渐增加剂量。2组均治疗12周。比较2组患者的血脂代谢、溶质清除情况、炎性因子、残余肾功能水平及药物不良反应发生率。结果治疗后,试验组和对照组低密度脂蛋白胆固醇(LDL-C)水平分别为(2.04±0.75),(2.70±0.68)mmol·L^(-1);总胆固醇(TC)分别为(5.37±1.43),(6.23±1.39)mmol·L^(-1);三酰甘油(TG)分别为(1.31±0.37),(1.71±0.49)mmol·L^(-1);高密度脂蛋白胆固醇(HDL-C)分别为(1.41±0.34),(0.97±0.19)mmol·L^(-1);肌酸酐清除率(Ccr)分别为(45.08±12.64),(32.66±9.22)L·w^(-1)/(1.73 m^(2));Kt/V分别为1.52±0.19,1.13±0.14;血肌酸酐(serum creatinine,Scr)分别为(356.35±74.07),(516.14±77.86)μmol·L^(-1);24小时尿蛋白(24 h U-pro)分别为(1.07±0.34),(1.33±0.34)g·L^(-1);残余肾功能(Residual renal function,RRF)水平分别为(6.15±1.57),(5.21±1.33)mL·min^(-1),差异均有统计学意义(均P<0.05)。试验组和对照组的药物不良反应发生率分别为20%,32%,差异无统计学意义(P>0.05)。结论阿托伐他汀具备降脂及抗炎作用,延缓残余肾功能下降速度,发挥肾保护作用。Objective To explore effects of atorvastatin on lipid metabolism and residual renal function(RRF)in peritoneal dialysis(PD)patients.Methods A total of 50 PD patients were randomly divided into treatment group(n=25)and control group(n=25).Control group was treated with lipid-lowering,anti-inflammatory and other routine treatment.On this basis,the test group received oral treatment with atorvastatin,the starting dose was 20 mg·d^(-1),the dose was gradually increased after 28 days according to the patient’s condition.Both groups were treated for 12 weeks,the levels of blood lipid metabolism,solute clearance,inflammatory factors,residual renal function,and incidence of adverse drug reactions were compared between the two groups.Results After treatment,low-density lipoprotein cholesterol(LDL-C)in treatment group and control group were (2.04±0.75)and(2.70±0.68)mmol·L^(-1),total cholesterol(TC)were(5.37±1.43)and(6.23±1.39)mmol·L^(-1);triacylglycerol(TG)were(1.31±0.37)and(1.71±0.49)mmol·L^(-1);high-density lipoprotein cholesterol(HDL-C)were(1.41±0.34)and(0.97±0.19)mmol·L^(-1);creatinine clearance rate(Ccr)were(45.08±12.64)and(32.66±9.22)L·w^(-1)/(1.73 m^(2));Kt/V were 1.52±0.19 and 1.13±0.14;serum creatinine(Scr)were(356.35±74.07)and(516.14±77.86)μmol·L^(-1);24 h urea protein were(1.07±0.34)and(1.33±0.34)g·L^(-1);residual renal function were(6.15±1.57)and(5.21±1.33)mL·min^(-1),there were significant differences(all P<0.05).The incidence of adverse drug reactions in treatment group and control group were 20%,32%,without significant difference(P>0.05).Conclusion Atorvastatin has lipid-lowering and anti-inflammatory effects,which can delay the rate of decline of residual renal function,and play a renoprotective role in PD patients.

关 键 词：阿托伐他汀 腹膜透析 血脂代谢 腹膜纤维化 残余肾功能 

分 类 号：R972.6[医药卫生—药品]