阿托伐他汀对维持性血液透析患者炎症因子的影响.doc

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1、临床医学论文-阿托伐他汀对维持性血液透析患者炎症因子的影响作者：李玉梅许菲菲陈文升【摘要】冃的：探讨不同剂量阿托伐他汀对维持性血液透析(maintenancehemodiabysisMHD)患者炎症因了的影响。方法：选择维持性血液透析的尿毒症患者65例，随机分为10mg组与20mg组，在常规治疗基础上，每晚分别口服阿托伐他汀lOmg和20mg，在治疗前、治疗1个月、治疗3个月时观察血清炎症指标:可溶性细胞间黏附分子KsICAM1)、白介素6(IL6)、血清高敏反应C蛋㈠(hsCRP)浓度及血压、血脂

2、、血压、营养指标。结果：两组患者治疗1、3个月后血清IL6、hsCRP、sICAM1水平较治疗前明显降低(P<0.05),其中20mg组较lOmg组降低更明显(P<0.01);两组治疗1个月时，收缩压及舒张压均有降低但无统计学意义(P>0.05)，3个月后血压较治疗前明显降低(PvO.05),但两组比较无统计学意义。两组治疗1、3个月后TC、TG、LDLC均较治疗前明显降低(PvO.05),3个月后20mg组TC、LDLC较1Omg组明显降低(PvO.05);两组治疗3个月后白蛋白浓度均较治疗前明显

3、增高(P<0.05)。结论：常规服用阿托伐他汀可改善维持性血液透析患者的微炎症状态及脂代谢紊乱。【关键词】尿毒症血液透析阿托伐他汀炎症因子AbstractObjective:Toinvestigatetheeffectsofdifferentdosesofatorvastatinonserumlevelsofinterlerkin6(TL6),hypersensitiveCreactiveprotein(hsCRP)andsolubleintercellularadhesionmolecule1(s

4、ICAM1)andbloodpressureonchronicrenalfailureduringmaintenancehemodialysis(MHD).Methods:SixtyfivepatientswithchronicrenalfailureduringMHDwererandomlydividedinto10mgatorvastatingroup(n=35)and20mgatovastatingroup(n=30)・Bothwereadministeredoncedailyfor12wee

5、ksinaddiliontoaroutinetherapy.SerumlevelsofIL6,hsCRP,sICAM1,TG,TC,LDLC,HB,BUN,CREandbloodpressureweremeasuredbeforeandin1and3monthsaftertreatment・ELISAmethodwasusedtomeasureIL6andsiCAM1andRadioimmunoassaywasusedtomeasurehsCRP.Rcsults:ThescrumlevelsofIL

6、6,hsCRPandsiCAM1weresignificantlydecreasedin1and3monthsaftertreatmentinbothgroupscomparetothosebeforetreatment(P<0.05),especiallyinthe20mgatorvastatingroup(P<0.01).Thebloodpressurewasloweredwithoutsignificantdifferencein1month(P>0・05)butwithstatistical

7、differencein3monthsinbothgroupscomparedtothatbeforetreatment(Pv0・05)andnodifferencewasnotedbetweenthe2groups・TC,TGandLDLCwasreducedin1and3months(Pv0・05)andmorereductionofTCandLDLCwasfoundinthe20mggroupin3months(Pv0.05)・TheserumlevelsofalbuminandHBweres

8、ignificantlyincreasedinbothgroups(P<0.05)・Conclusion:Atorvastatininterventionmayimprovethemicroinflammatorystateand1ipidmetabolicdisorderinpatientsduringMHD.Keywordsuremiahemodialysisatorvastatininflammatorycytokine2000年Schooling等［1］捉出尿