机构地区:[1]甘肃省武威肿瘤医院肾脏内分泌科,733000
出 处:《中国实用医药》2021年第28期110-112,共3页China Practical Medicine
摘 要:目的 探讨阿托伐他汀钙片用于非透析的糖尿病肾病患者对血清血管内皮生长因子(VEGF)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平的影响。方法 131例非透析的2型糖尿病患者,根据尿白蛋白排泄率(UAER)分为单纯糖尿病组(45例, UAER<30 mg/24 h)、微量白蛋白尿组(44例,UAER 30~300 mg/24 h)及大量白蛋白尿组(42例, UAER>300 mg/24 h)。三组患者均口服阿托伐他汀钙片,检测并比较三组患者治疗前后血清Lp-PLA2、VEGF、UAER水平。结果 治疗前,大量白蛋白尿组UAER(333.11±18.29)mg/24 h高于微量白蛋白尿组的(182.34±51.50)mg/24 h、单纯糖尿病组的(23.02±3.16)mg/24 h,且微量白蛋白尿组UAER高于单纯糖尿病组,差异有统计学意义(P<0.05);治疗2周后,单纯糖尿病组、微量白蛋白尿组、大量白蛋白尿组患者UAER分别为(16.18±3.54)、(144.50±44.70)、(323.11±20.22)mg/24 h,均低于治疗前的(23.02±3.16)、(182.34±51.50)、(333.11±18.29)mg/24 h,差异有统计学意义(P<0.05)。治疗前,单纯糖尿病组血清VEGF、Lp-PLA2水平低于微量白蛋白尿组、大量白蛋白尿组,且微量白蛋白尿组血清VEGF、Lp-PLA2水平低于大量白蛋白尿组,差异有统计学意义(P<0.05);治疗2周后,三组患者的血清VEGF、Lp-PLA2均较治疗前下降,且单纯糖尿病组下降幅度大于微量白蛋白尿组、大量白蛋白尿组,微量白蛋白尿组下降幅度大于大量白蛋白尿组,差异具有统计学意义(P<0.05)。结论 阿托伐他汀钙片在糖尿病肾病的整个病程中患者均可受益,但在早期糖尿病肾病患者获益更大。通过检测血清Lp-PLA2、VEGF有助于早期诊断糖尿病肾脏疾病,提前干预治疗,延缓病程发展,改善患者预后。Objective To discuss the effect of atovastatin calcium tablets on serum vascular endothelial growth factor(VEGF)and lipoprotein-associated phospholipase A2(Lp-PLA2)in non-dialysis patients with diabetic nephropathy.Methods According to the urinary albumin excretion rate(UAER),131 non-dialysis patients with type 2 diabetes mellitus were divided into simple diabetes group(45 cases,UAER<30 mg/24 h)and microalbuminuria group(44 cases,UAER 30-300 mg/24 h)and massive albuminuria group(42 cases,UAER>300 mg/24 h).Patients in all three groups took oral atorvastatin calcium tablets,and serum Lp-PLA2,VEGF,and UAER levels before and after treatment were measured and compared in the three groups.Results Before treatment,UAER(333.11±18.29)mg/24 h in the massive albuminuria group was higher than(182.34±51.50)mg/24 h in the microalbuminuria group and(23.02±3.16)mg/24 h in the simple diabetes group,and UAER in the microalbuminuria group was higher than that in the simple diabetes group.All the differences were statistically significant(P<0.05).After 2 weeks of treatment,UAER of the simple diabetes group,microalbuminuria group and massive albuminuria group were(16.18±3.54),(144.50±44.70)and(323.11±20.22)mg/24 h,respectively,which were lower than(23.02±3.16),(182.34±51.50)and(333.11±18.29)mg/24 h before treatment,and the differences were statistically significant(P<0.05).Before treatment,the serum VEGF and Lp-PLA2 levels in the simple diabetes group were lower than those in the microalbuminuria group and massive albuminuria group,and the serum VEGF and Lp-PLA2 levels in the microalbuminuria group were lower than those in the massive albuminuria group.All the differences were statistically significant(P<0.05).After 2 weeks of treatment,the serum VEGF and Lp-PLA2 decreased in all three groups compared with those before treatment,and the decrease in the simple diabetes group was greater than those in the microalbuminuria group and massive albuminuria group,and the decrease in the microalbuminuria group was greater than that i
关 键 词:阿托伐他汀钙片 糖尿病肾病 脂蛋白相关磷脂酶A2 血管内皮生长因子
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