阿托伐他汀抑制核因子κB65介导炎症反应降低维持性血液透析病人心血管并发症发生率
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摘要
目的:观察阿托伐他汀抑制核因子κB 65(NF-κB 65)介导炎症反应降低维持性血液透析(maintenance hemodialysis,MHD)病人心血管并发症发生率的效果。方法:选取2016-03～2018-01期间我院收治的90例MHD病人,采取数字表将其随机平均分为2组,对照组予以常规治疗,实验组加用阿托伐他汀,比较2组治疗前后NF-κB 65介导炎症反应指标[NF-κB 65、白细胞介素1(IL-1)、白细胞介素6(IL-6)、单核细胞趋化因子1(MCP-1)、C反应蛋白(CRP)水平]、肾功能与血脂[血尿素氮(BUN)、血肌酐(Scr)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)]、心肌损伤标志物、冠脉小血管狭窄程度,并观察2组心血管并发症情况。结果:治疗后,实验组NF-κB 65表达水平、IL-1、IL-6、MCP-1、CRP、LDL、超敏肌钙蛋白水平均明显低于对照组(P<0.05);实验组治疗后狭窄血管与轻度狭窄血管所占比例显著低于对照组(P<0.05);实验组心血管并发症发生率明显低于对照组(P<0.05)。结论:阿托伐他汀药物可能以抑制NF-κB65表达方式,降低MHD病人炎症反应,促进血脂恢复,减少心肌损伤,改善冠脉小血管狭窄情况,降低心血管并发症风险。
Objective:To observe the effects of atorvastatin inhibiting nuclear factor-κB 65(NF-κB 65)-mediated inflammatory response and reducing the incidence of cardiovascular complications in patients undergoing maintenance hemodialysis(MHD).Methods:A total of 90 patients undergoing MHD who were admitted to the hospital during the period from March 2016 to January 2018 were selected and randomly divided into two groups.The control group was given routine treatment and on this basis,the experimental group was additionally treated with atorvastatin.The NF-κB 65-mediated inflammatory response indexes [NF-κB 65,interleukin-1(IL-1),interleukin-6(IL-6),monocyte chemoattractant 1(MCP-1),C reactive protein(CRP) ],renal function and blood lipids [blood urea nitrogen(BUN),serum creatinine(Scr),total cholesterol(TC),low density lipoprotein(LDL),high density lipoprotein(HDL) ],myocardial injury markers and the degree of coronary micro-vascular stenosis were compared between the two groups before and after treatment.The incidence of cardiovascular complications in both groups was observed.Results:The expression level of NF-κB 65,levels of IL-1,IL-6,MCP-1,CRP,LDL and high-sensitivity troponin were significantly lower in the experimental group than in the control group after treatment(P<0.05).The proportions of stenotic vessels and mild stenotic vessels were significantly lower in the experimental group than in the control group after treatment(P<0.05).The incidence of cardiovascular complications in the experimental group was significantly lower than that in the control group(P<0.05).Conclusion:Atorvastatin may decrease inflammatory response in patients undergoing MHD by inhabiting the expression of NF-κB 65.It can promote the recovery of blood lipids,reduce myocardial injury,improve coronary microvascular stenosis and reduce the risk of cardiovascular complications.
Objective:To observe the effects of atorvastatin inhibiting nuclear factor-κB 65(NF-κB 65)-mediated inflammatory response and reducing the incidence of cardiovascular complications in patients undergoing maintenance hemodialysis(MHD).Methods:A total of 90 patients undergoing MHD who were admitted to the hospital during the period from March 2016 to January 2018 were selected and randomly divided into two groups.The control group was given routine treatment and on this basis,the experimental group was additionally treated with atorvastatin.The NF-κB 65-mediated inflammatory response indexes [NF-κB 65,interleukin-1(IL-1),interleukin-6(IL-6),monocyte chemoattractant 1(MCP-1),C reactive protein(CRP) ],renal function and blood lipids [blood urea nitrogen(BUN),serum creatinine(Scr),total cholesterol(TC),low density lipoprotein(LDL),high density lipoprotein(HDL) ],myocardial injury markers and the degree of coronary micro-vascular stenosis were compared between the two groups before and after treatment.The incidence of cardiovascular complications in both groups was observed.Results:The expression level of NF-κB 65,levels of IL-1,IL-6,MCP-1,CRP,LDL and high-sensitivity troponin were significantly lower in the experimental group than in the control group after treatment(P<0.05).The proportions of stenotic vessels and mild stenotic vessels were significantly lower in the experimental group than in the control group after treatment(P<0.05).The incidence of cardiovascular complications in the experimental group was significantly lower than that in the control group(P<0.05).Conclusion:Atorvastatin may decrease inflammatory response in patients undergoing MHD by inhabiting the expression of NF-κB 65.It can promote the recovery of blood lipids,reduce myocardial injury,improve coronary microvascular stenosis and reduce the risk of cardiovascular complications.
引文
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[12]高菊华,高小平,潘速跃.阿托伐他汀强化治疗可减少大脑中动脉支架置入后脑血管事件的发生[J].南方医科大学学报,2016; 36(3):356-360
[13]鲍恩昊,朱爱国,王志宏.维生素C联合阿托伐他汀钙对血液透析病人氧化应激与微炎症状态的影响[J].海南医学院学报,2016; 22(5):431-434
[14]刘云豹,赵德纯,胡庆,等.阿托伐他汀钙片治疗尿毒症透析病人微炎症因子白介素的临床研究[J].湖南中医药大学学报,2016; 36(A01):93-94
[15]唐方平.缬沙坦联合阿托伐他汀改善维持性血液透析病人微炎症、营养状态的效果[J].实用临床医药杂志,2016; 20(11):163-164
[16]徐健强,赵国军,王燕,等.阿托伐他汀的抗炎作用及其机制的研究进展[J].中国动脉硬化杂志,2016; 24(4):419-423
[2]周丹,张芃,张照英,等.维持性血液透析尿毒症病人外周血MCP-1、TNF-α、IL-6和hs-CRP水平对血管通路功能的影响[J].临床误诊误治,2018; 31(2):91-94
[3]杨小华,邓有琦,肖健.高通量血液透析对维持性血液透析病人胰岛素抵抗及心脏结构和功能的改善效果分析[J].临床和实验医学杂志,2016; 15(17):1698-1701
[4]蔡晓容,王红梅,周俊文,等.阿托伐他汀仿制药和原研药疗效与安全性的系统评价[J].中国药房,2016; 27(24):3393-3396
[5]魏萍,罗红丽,邓静敏,等.协同护理模式对维持性血液透析病人自我管理行为和生活质量的影响[J].河北医学,2016; 22(1):163-166
[6]南静.左卡尼汀联合阿托伐他汀钙对维持性血液透析病人微炎性反应状态的影响[J].中国医师进修杂志,2015; 38(4):298-300
[7]蒋桂英,李慧欣.不同剂量阿托伐他汀钙对高血压合并早期肾损害病人的治疗效果分析[J].中国药物与临床,2017; 17(7):1016-1019
[8]李亚如,丁莉娟,高东来.阿托伐他汀预防造影剂肾病的研究进展[J].中国药物与临床,2017; 17(2):216-218
[9]陈小盼,陈竑,陈韩,等.阿托伐他汀片对2型糖尿病肾病病人血清chemerin水平的影响[J].海南医学,2017; 28(16):2596-2598
[10]刘宝宝.阿托伐他汀治疗高血压肾病疗效及机制研究[J].现代中西医结合杂志,2017; 26(4):421-423
[11]王先惠.阿托伐他汀钙片对高血压早期肾损害病人肾功能影响研究[J].现代中西医结合杂志,2016; 25(8):850-852
[12]高菊华,高小平,潘速跃.阿托伐他汀强化治疗可减少大脑中动脉支架置入后脑血管事件的发生[J].南方医科大学学报,2016; 36(3):356-360
[13]鲍恩昊,朱爱国,王志宏.维生素C联合阿托伐他汀钙对血液透析病人氧化应激与微炎症状态的影响[J].海南医学院学报,2016; 22(5):431-434
[14]刘云豹,赵德纯,胡庆,等.阿托伐他汀钙片治疗尿毒症透析病人微炎症因子白介素的临床研究[J].湖南中医药大学学报,2016; 36(A01):93-94
[15]唐方平.缬沙坦联合阿托伐他汀改善维持性血液透析病人微炎症、营养状态的效果[J].实用临床医药杂志,2016; 20(11):163-164
[16]徐健强,赵国军,王燕,等.阿托伐他汀的抗炎作用及其机制的研究进展[J].中国动脉硬化杂志,2016; 24(4):419-423