【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)患者外周血核因子-κB(NF-κB)p65(Ser536)的磷酸化水平、血清炎症因子水平及胰岛素敏感性的影响。方法将72例老年早期DN患者,随机分为两组,DN1组37例给予阿托伐他汀钙片10 mg/d,DN2组35例给予阿托伐他汀钙片20 mg/d,疗程均为16周。分别于治疗前后测定两组患者外周血NF-κB p65磷酸化水平、血清超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平及胰岛素抵抗指数(HOMA-IR)。结果两组患者治疗16周后hs-CRP、IL-6、IL-1β、TNF-α水平及HOMA-IR均较治疗前降低(P<0.05),DN2组降低更明显(P<0.05)。DN2组治疗后外周血NF-κB p65磷酸化水平较治疗前降低(P<0.05),而DN1组与治疗前比较,差异无统计学意义(P>0.05)。结论阿托伐他汀可降低早期DN患者外周血NF-κB p65的活性及hs-CRP、TNF-α、IL-6、IL-1β水平,降低HOMA-IR,改善患者炎症状态及胰岛素敏感性,且呈一定的剂量依赖性。更多还原

【Abstract】 Objective To observe the effects of different doses of atorvastatin on the phosphorylation of nuclear factor-kappa B( NF-κB) p65( Ser536) in peripheral blood,the levels of serum inflammatory factors,and insulin sensitivity among elderly patients with early diabetic nephropathy( DN). Methods Seventy-two elderly patients with early DN were randomly divided into two groups,37 cases in the DN1 group were given atorvastatin at a dose of 10 mg per day for 16 weeks,while 35 cases in the DN2 group were given atorvastatin at a dose of 20 mg per day for 16 weeks. The levels of phosphorylation of NF-κB p65 in peripheral blood,serum high-sensitivity C-reactive protein( hs-CRP),interleukin-6( IL-6),interleukin-1β( IL-1β) and tumor necrosis factor-α( TNF-α),and insulin resistance index( HOMA-IR)were measured before and after treatment in two groups. Results After a sixteen-week treatment,the levels of hs-CRP,IL-6,IL-1β and TNF-α,and HOMA-IR decreased in two groups in contrast with those before treatment( P < 0. 05),and the decrease in the DN2 group was more significant( P < 0. 05). The level of phosphorylation of NF-κB p65 in peripheral blood decreased significantly after treatment in DN2 group( P < 0. 05),which showed no significant changes in the DN1 group after treatment in contrast with that before treatment( P > 0. 05).Conclusion Atorvastatin can reduce the levels of NF-κB p65,hs-CRP,TNF-α,IL-6 and IL-1β,and HOMA-IR among patients with early DN. It may benefit the patients by improving inflammatory status and insulin sensitivity in a dose-dependent manner.更多还原