王莉, 周观彦. 阿托伐他汀三联用药方案对高血压肾病患者血清炎性因子及血液流变学的影响[J]. 临床肾脏病杂志, 2017, 17(11): 676-679. DOI: 10.3969/j.issn.1671-2390.2017.11.008
    引用本文: 王莉, 周观彦. 阿托伐他汀三联用药方案对高血压肾病患者血清炎性因子及血液流变学的影响[J]. 临床肾脏病杂志, 2017, 17(11): 676-679. DOI: 10.3969/j.issn.1671-2390.2017.11.008
    WANG Li, ZHOU Guan-yan. The impact of atorvastatin on hemorheology and inflammatory cytokines of patients with hypertensive nephropathy[J]. Journal of Clinical Nephrology, 2017, 17(11): 676-679. DOI: 10.3969/j.issn.1671-2390.2017.11.008
    Citation: WANG Li, ZHOU Guan-yan. The impact of atorvastatin on hemorheology and inflammatory cytokines of patients with hypertensive nephropathy[J]. Journal of Clinical Nephrology, 2017, 17(11): 676-679. DOI: 10.3969/j.issn.1671-2390.2017.11.008

    阿托伐他汀三联用药方案对高血压肾病患者血清炎性因子及血液流变学的影响

    The impact of atorvastatin on hemorheology and inflammatory cytokines of patients with hypertensive nephropathy

    • 摘要: 目的 探讨阿托伐他汀三联用药方案对高血压肾病患者血清炎性因子及血液流变学的影响。方法 选择2014年3月至2015年2月在黄冈市英山县人民医院肾内科就诊的134例高血压肾病患者为研究对象,根据入院时间按照单双号随机分为观察组和对照组各67例,对照组使用氨氯地平(2.5 mg,1次/d,餐后服用)加缬沙坦(80 mg,1次/d,进餐时或空腹服用)二联用药方案,观察组使用阿托伐他汀(20 mg,1次/d,晚上睡前服用)、氨氯地平(2.5 mg,1次/d,餐后服用)、缬沙坦(80 mg,1次/d,进餐时或空腹服用)三联用药方案,治疗3个月后,比较2组肾功能、炎性因子、血液流变学、不良反应等指标。结果 治疗前2组肾功能、炎性因子、血液流变学指标无统计学差异(P>0.05)。观察组肾功能、炎性因子、血液流变学指标在治疗前后有统计学差异(P < 0.05);对照组肾功能、炎性因子指标在治疗后有变化(P < 0.05),但治疗前后的血液流变学指标无统计学差异(P>0.05)。2组治疗后比较,治疗组的尿白蛋白、血肌酐、尿素氮、清降钙素原、C反应蛋白、血沉、高切全血黏度、低切全血黏度、血浆黏度均明显低于对照组(P < 0.05或P < 0.01)。2组恶心、呕吐、头痛等不良反应比较无统计学意义(x2=0.085,P>0.05)。结论 阿托伐他汀三联用药方案有助于保护高血压肾病患者肾功能,可能与降低血清炎性因子水平、改善血液流变学指标等有关。

       

      Abstract: Objective To explore the effects of atorvastatin triple regimen on serum inflammatory factors and hemorheology in patients with hypertensive nephropathy. Methods 134 patients with hypertensive nephropathy from March 2014 to February 2015 in the Department of Nephrology in Yingshan County People's Hospital were enrolled in this study and numbered by admission time, and then randomly divided into the observation group (n=67) and the control group (n=67) according to the odd or even number. The control group was treated with amlodipine (2.5 mg, 1 time/day, taken after meals) and valsartan (80 mg, 1 time/day, taken at meals or on an empty stomach), and the observation group was treated with the triple regimen of atorvastatin (20 mg, 1 time/day, taken before bed-time), amlodipine (2.5 mg, 1 time/day, taken after meals) and valsartan (80 mg, 1 time/day, taken at meal or empty stomach). After 3 months of treatment, the renal function, inflammatory factors, hemodynamics, adverse reactions and other indicators were compared between the two groups.Results After 3 months of treatment, the levels of urinary albumin (Alb), serum creatinine (SCr) and blood urea nitrogen (BUN) in the observation group were significantly lower than those in the control group (P<0.05). The levels of serum procalcitonin, C-reactive protein and erythrocyte sedimentation were significantly lower in the observation group than those in the control group (P<0.01). The levels of high blood viscosity, low shear whole blood viscosity and plasma viscosity were significantly lower I nthe observation group than those in the control group (P<0.05). There were no significant differences in nausea, vomiting and headache between the two groups (10.45% vs. 8.96%) (x2=0.085, P>0.05).Conclusions Atorvastatin triple regimen is helpful in protecting renal function in patients with hypertensive nephropathy, which may be related to decreases in serum levels of inflammatory factors and improvements in hemorheology.

       

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