阿托伐他汀联合缬沙坦对慢性肾炎患者hs-CRP、TNF-α、IL-6水平的影响
| 作者: |
1徐向君
1 宜兴市人民医院肾内科，江苏 宜兴 214200 |
| 通讯: |
徐向君
Email: sdhbnjklh@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2021.12.021 |
摘要
目的：观察阿托伐他汀联合缬沙坦对慢性肾炎患者的临床疗效及对其炎症因子水平的影响。方法：纳入2016年7月至2019年8月于宜兴市人民医院治疗的103例慢性肾炎患者，随机分为缬沙坦组(n=51)与联合组(n=52)，2组患者均接受饮食控制、活性维生素D等基础治疗。在此基础上，缬沙坦组接受缬沙坦治疗，联合组接受缬沙坦治疗的同时给予阿托伐他汀。检测治疗前后患者的血肌酐(serum creatinine，SCr)、24 h尿蛋白、血清尿素氮(blood urea nitrogen，BUN)、肿瘤坏死因子-α(tumor necrosis factor-α，TNF-α)、白细胞介素-6(interleukin-6，IL-6)、超敏C反应蛋白(hypersensitive C-reactive protein，hs-CRP)水平，评估整体疗效，记录患者治疗期间头痛、肠胃不适、乏力等不良反应的发生情况。结果：治疗前，2组3项肾功能指标的差异均无统计学意义(均P>0.05)；治疗后，2组肾功能指标均有显著改善，且联合组BUN、24 h尿蛋白、SCr水平均低于缬沙坦组，差异均有统计学意义(均P<0.05)；治疗前，2组3项炎症因子水平趋于一致(P>0.05)；治疗后，2组炎症因子水平显著下降，且联合组hs-CRP、TNF-α、IL-6水平均低于缬沙坦组，差异均有统计学意义(均P<0.05)。治疗后，联合组血脂、血压水平均显著优于缬沙坦(P<0.05)；在疗效评估方面，联合组总有效率较缬沙坦组更高，差异有统计学意义(P<0.0.5)；在不良反应方面，2组不良反应发生率基本一致，差异无统计学意义(P>0.05)。结论：在临床慢性肾炎患者的治疗中，与单一缬沙坦治疗相比，缬沙坦与阿托伐他汀的联合给药方案的临床疗效更佳，对患者肾功能及炎症因子的改善作用更明显，且安全可靠，未见明显不良反应。
关键词：
慢性肾炎；缬沙坦；阿托伐他汀；肾功能；炎症因子；对照研究
Effect of atorvastatin combined with valsartan on hs-CRP, TNF-α and IL-6 levels in patients with chronic nephritis
CorrespondingAuthor: XU Xiangjun Email: sdhbnjklh@163.com
DOI: 10.3978/j.issn.2095-6959.2021.12.021
Abstract
Objective: To observe the clinical efficacy of atorvastatin combined with valsartan in the treatment of patients with chronic nephritis and the effect on the level of inflammatory factors. Methods: A total of 103 patients with chronic nephritis treated in Yixing People’s Hospital from July 2016 to August 2019 were enrolled and randomly divided into a valsartan group (n=51) and a combined group (n=52). On the basis of diet control and active vitamin D treatment, the valsartan group was treated with valsartan, and the combined group received valsartan and atorvastatin. The levels of serum creatinine (SCr), 24 h urinary protein, serum urea nitrogen (BUN), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and hypersensitive C-reactive protein (hs-CRP) were measured before and after the treatment, and the overall efficacy was evaluated. The incidence of adverse reactions such as headache, gastrointestinal discomfort and fatigue during treatment was recorded. Results: There were no significant differences in 3 renal function indexes between the 2 groups before the treatment (P>0.05), and the renal function indexes of the 2 groups were significantly improved after the treatment. The levels of BUN, 24 h urinary protein and SCr in the combined group were lower than those in the valsartan group (P<0.05). Before treatment, the levels of three inflammatory cytokines in the 2 groups were consistent (P>0.05), but after the treatment, the levels of inflammatory cytokines in the 2 groups were significantly decreased, and the levels of hs-CRP, TNF-α, and IL-6 in the combined group were lower than those in the valsartan group, with significant differences (P<0.05). The total effective rate of the combined group was higher than that of the valsartan group, and the difference was significant (P<0.0.5). Compared with the combination group, the incidence of adverse reactions in the valsartan group was same basically (P>0.05). Conclusion: Compared with valsartan alone, valsartan combined with atorvastatin has better clinical efficacy in the treatment of chronic nephritis, which not only significantly improves renal function and inflammatory factors, but also is safe and reliable, without obvious increased adverse reaction.
Keywords：
chronic nephritis; valsartan; atorvastatin; renal function; inflammatory cytokines; control study