【摘要】 目的观察不同剂量阿托伐他汀对老年早期糖尿病肾病(DN)患者外周血单个核细胞中核因子-κB(NF-κB)P65(ser536)的磷酸化水平、血清炎症因子水平(hs-CRP、TNF-α、IL-6、IL-1β)及尿白蛋白排泄率(UAER)的影响。方法将72例2型糖尿病早期DN老年患者,半随机分为两组,分别给予阿托伐他汀钙片10 mg/d(DN1组,37例)和20 mg/d(DN2组,35例),疗程16周。测定两组患者治疗前和治疗16周后外周血NF-κB P65的磷酸化水平、血清炎症因子水平、UAEA、血脂(TC、TG、DHL-C、LDL-C)。结果两组患者治疗后外周血NF-κB P65水平、血清炎症因子水平、TC及LDL-C均较治疗前降低(P<0.01或P<0.05),以DN2组降低更显著。DN2组治疗后UAER较治疗前显著降低(P<0.01),DN1组无显著下降(P>0.05)。结论阿托伐他汀在降低血脂的同时可降低外周血NF-κB P65的活性、血清炎症因子hs-CRP、TNF-α、IL-6、IL-1β水平,改善患者炎症状态,减少尿蛋白,且呈剂量依赖性。更多还原

【Abstract】 Objective To observe the effects of different doses of atorvastatin on phosphorylation of nuclear factor-kappa B( NF-κB) P65( ser536) in peripheral blood mononuclear cells,on the levels of serum inflammatory factors,including high sensitivity C reactive protein( hs-CRP),tumor necrosis factor-α( TNF-α),interleukin-6( IL-6),interleukin-1β( IL-1β),and on urinary albumin excretion rate( UAER) in the elderly patients with early diabetic nephropathy. Methods The patients( n = 72) of type 2 diabetes with early nephropathy were randomly divided into two groups,The patients were given atorvastatin 10 mg /d in DN1 group and atorvastatin 20 mg /d in DN2 group for sixteen weeks. Levels of NF- κB,serum inflammation factors,UAER,Total cholesterol( TC),triglyceride( TG),low density lipoprotein( LDL-C) and hight density lipoprotein( HDL-C) were measured before treatment and after treatment for sixteen weeks. Results After sixteen weeks of treatment,the levels of NF-kB,serum inflammation factors,TC and LDL were reduced( P < 0. 05 or P < 0. 01) in two group. DN2 group decreased more significantly. UAER were reduced( P < 0. 01) in DN2 group. There was no significant changes in DN1 group( P > 0. 05). Conclusion Atorvastatin can reduce activity of NF-κB,levels of hs-CRP,TNF-α,IL-6,IL-1β,TC,and LDL in the olderly patients with type 2 diabetic pristine nephropathy. Atorvastatin may benefit patients with diabetes mellitus by ameliorating inflammatory stats,as well as reducing urinary albumin,in a dose-dependent manner.更多还原