辛伐他汀联合阿司匹林对糖尿病肾脏微血管病变患者脂代谢和炎性反应的影响及安全性分析
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摘要
目的探讨辛伐他汀联合阿司匹林对糖尿病肾脏微血管病变患者脂代谢和炎性反应的影响及其安全性。方法选取2016年2月至2017年10月本院收治的110例糖尿病肾脏微血管病变患者为研究对象,按照随机数表法将入选患者分为观察组和对照组,每组各55例。观察组患者采用辛伐他汀联合阿司匹林治疗,对照组患者仅采用阿司匹林单药治疗,比较两组患者治疗前后血脂水平、炎性因子水平及不良反应发生率。结果治疗后,两组患者总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、P-选择素、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、高敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)、白介素-1β(interleukin-1β,IL-1β)、细胞间黏附分子(intercelluar adhesion molecule,ICAM)水平均显著低于本组治疗前(P_均<0.05),高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)水平均显著高于本组治疗前(P_均<0.05);且观察组患者TC、TG、LDL-C、P-选择素、TNF-α、hs-CRP、IL-1β、ICAM水平均显著低于同期对照组(P_均<0.05),HDL-C水平显著高于同期对照组(P <0.05)。观察组患者不良反应总发生率显著低于对照组(P <0.05)。结论辛伐他汀联合阿司匹林能够显著降低糖尿病肾脏微血管病变患者血脂和炎性因子水平,且安全性较好。
Objective To investigate the effect of Simvastatin combined with Aspirin on lipid metabolism and in?ammatory response in patients with diabetic renal microangiopathy and its safety. Method 110 patients with diabetic renal microangiopathy treated in our hospital from February 2016 to October 2017 were selected as the subjects of the study, according to the method of random number table, the selected patients were divided into observation group(n = 55) and control group(n = 55). Patients in observation group were treated with Simvastatin combined with Aspirin, while patients in control group were treated with Aspirin only, he levels of blood lipid, in?ammatory factors and the incidence of adverse reactions were compared between the two groups before and after treatment.Result After treatment, the levels of total cholesterol(TC), triglyceride(TG), low density lipoprotein-cholesterol(LDL-C), P-selectin,tumor necrosis factor-α(TNF-α), high sensitivity C-reactive protein(hs-CRP), interleukin-1β(IL-1β), intercelluar adhesion molecule(ICAM) in the two groups were signi?cantly lower than those before treatment(P_(all)< 0.05), the level of high density lipoproteincholesterol(HDL-C) was signi?cantly higher than that before treatment(P_(all)< 0.05), the levels of TC, TG, LDL-C, P-selectin, TNF-α,hs-CRP, IL-1β, ICAM in observation group were signi?cantly lower than those in control group(P_(all)< 0.05), the level of HDL-C was signi?cantly higher than that of control group(P < 0.05). Conclusion Simvastatin combined with Aspirin can signi?cantly reduce the levels of blood lipid and in?ammatory factors in patients with diabetic renal microangiopathy, and the safety is good.
Objective To investigate the effect of Simvastatin combined with Aspirin on lipid metabolism and in?ammatory response in patients with diabetic renal microangiopathy and its safety. Method 110 patients with diabetic renal microangiopathy treated in our hospital from February 2016 to October 2017 were selected as the subjects of the study, according to the method of random number table, the selected patients were divided into observation group(n = 55) and control group(n = 55). Patients in observation group were treated with Simvastatin combined with Aspirin, while patients in control group were treated with Aspirin only, he levels of blood lipid, in?ammatory factors and the incidence of adverse reactions were compared between the two groups before and after treatment.Result After treatment, the levels of total cholesterol(TC), triglyceride(TG), low density lipoprotein-cholesterol(LDL-C), P-selectin,tumor necrosis factor-α(TNF-α), high sensitivity C-reactive protein(hs-CRP), interleukin-1β(IL-1β), intercelluar adhesion molecule(ICAM) in the two groups were signi?cantly lower than those before treatment(P_(all)< 0.05), the level of high density lipoproteincholesterol(HDL-C) was signi?cantly higher than that before treatment(P_(all)< 0.05), the levels of TC, TG, LDL-C, P-selectin, TNF-α,hs-CRP, IL-1β, ICAM in observation group were signi?cantly lower than those in control group(P_(all)< 0.05), the level of HDL-C was signi?cantly higher than that of control group(P < 0.05). Conclusion Simvastatin combined with Aspirin can signi?cantly reduce the levels of blood lipid and in?ammatory factors in patients with diabetic renal microangiopathy, and the safety is good.
引文
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[7]李洪梅.糖尿病肾脏疾病的诊治进展[J].中国医刊,2018,53(4):9-12.
[8]郭卫.糖尿病微血管病变及治疗药物的研究进展[J].实用糖尿病杂志,2018,14(1):72.
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[10]龙艳,苏珂,彭鹰,等.血糖波动与氧化应激对2型糖尿病微血管病变的影响[J].中华老年心脑血管病杂志,2014,16(2):147-150.
[11]李华,冯振东,叶树新,等.高密度脂蛋白胆固醇水平与2型糖尿病微血管病变的相关性[J].现代医学,2014,27(2):121-124.
[12]陈燕铭,唐喜香,穆攀伟.血糖波动对糖尿病微血管病变的影响[J].中华内分泌代谢杂志,2016,32(9):795-798.
[13]田爱荣,田晨光.P-选择素及瘦素与2型糖尿病及大血管病变的相关性[J].中华实用诊断与治疗杂志,2016,30(7):687-689.
[14]苏冬娜,王娈,马瑞欣.早期糖尿病肾病病人RIP140与炎症因子的关系[J].青岛大学医学院学报,2017,30(1):70-73.
[15]华燕,胡伟,蒋成霞,等.糖尿病患者血清中可溶性细胞间黏附分子1、单核细胞趋化蛋白1、白细胞介素-8水平与患者微血管病变及心血管事件的关系[J].中国卫生检验杂志,2018,28(11):94-96.
[16]Ittaman SV,Vanwormer JJ,Rezkalla SH.The role of aspirin in the prevention of cardiovascular disease[J].Clin Med Res,2014,12(3-4):147-154.
[17]中华医学会老年医学分会,《中华内科杂志》编辑委员会,《中华老年医学杂志》编辑委员会.阿司匹林在动脉粥样硬化性心血管疾病中的临床应用:中国专家共识(2016)[J].中华内科杂志,2017,56(1):68-80.
[18]曹凯.终末期糖尿病肾病血液透析患者阿司匹林抵抗现象分析[J].临床和实验医学杂志,2016,15(10):1027-1029.
[19]王伟国.辛伐他汀干预对高血压治疗的影响[J].中国医刊,2014,49(1):54-55.
[20]徐海燕,刘冬,王文刚,等.他汀类药物与常见心血管药物相互作用的研究进展[J].中国药房,2016,26(11):1582-1584.
[2]中华医学会糖尿病学分会微血管并发症学组.糖尿病肾病防治专家共识(2014年版)[J].中国糖尿病杂志,2014,6(11):792-801.
[3]Nagata M,Yamaguchi Y,Toki D,et al.Complex glomerular pathology of thrombotic microangiopathy and focal segmental glomerulosclerosis forms tumor-like mass in a renal transplant donor with severe renovascular hypertension[J].CEN Case Reports,2017,6(1):12-17.
[4]王彦梅,周厚广,黄延焱.脂肪组织功能失调与糖尿病性动脉粥样硬化[J].医学综述,2016,22(13):2596-2599.
[5]李竞,毛拓华.糖尿病微血管病变[J].微循环学杂志,2013,23(2):1-4.
[6]王慧卿,王桂英,尉杰忠.2型糖尿病肾病危险因素的临床分析[J].山西医药杂志,2017,46(1):50-52.
[7]李洪梅.糖尿病肾脏疾病的诊治进展[J].中国医刊,2018,53(4):9-12.
[8]郭卫.糖尿病微血管病变及治疗药物的研究进展[J].实用糖尿病杂志,2018,14(1):72.
[9]吴明昊,刘剑,高宇,等.脂质调控与糖尿病肾病关系的研究进展[J].医学与哲学,2016,37(18):66-69.
[10]龙艳,苏珂,彭鹰,等.血糖波动与氧化应激对2型糖尿病微血管病变的影响[J].中华老年心脑血管病杂志,2014,16(2):147-150.
[11]李华,冯振东,叶树新,等.高密度脂蛋白胆固醇水平与2型糖尿病微血管病变的相关性[J].现代医学,2014,27(2):121-124.
[12]陈燕铭,唐喜香,穆攀伟.血糖波动对糖尿病微血管病变的影响[J].中华内分泌代谢杂志,2016,32(9):795-798.
[13]田爱荣,田晨光.P-选择素及瘦素与2型糖尿病及大血管病变的相关性[J].中华实用诊断与治疗杂志,2016,30(7):687-689.
[14]苏冬娜,王娈,马瑞欣.早期糖尿病肾病病人RIP140与炎症因子的关系[J].青岛大学医学院学报,2017,30(1):70-73.
[15]华燕,胡伟,蒋成霞,等.糖尿病患者血清中可溶性细胞间黏附分子1、单核细胞趋化蛋白1、白细胞介素-8水平与患者微血管病变及心血管事件的关系[J].中国卫生检验杂志,2018,28(11):94-96.
[16]Ittaman SV,Vanwormer JJ,Rezkalla SH.The role of aspirin in the prevention of cardiovascular disease[J].Clin Med Res,2014,12(3-4):147-154.
[17]中华医学会老年医学分会,《中华内科杂志》编辑委员会,《中华老年医学杂志》编辑委员会.阿司匹林在动脉粥样硬化性心血管疾病中的临床应用:中国专家共识(2016)[J].中华内科杂志,2017,56(1):68-80.
[18]曹凯.终末期糖尿病肾病血液透析患者阿司匹林抵抗现象分析[J].临床和实验医学杂志,2016,15(10):1027-1029.
[19]王伟国.辛伐他汀干预对高血压治疗的影响[J].中国医刊,2014,49(1):54-55.
[20]徐海燕,刘冬,王文刚,等.他汀类药物与常见心血管药物相互作用的研究进展[J].中国药房,2016,26(11):1582-1584.