摘要
目的 :通过观察舒降之对维持性血液透析患者相关炎症和营养指标白介素 - 6 (IL - 6 )、高敏C反应蛋白 (hs-CRP)、白蛋白、前白蛋白、转铁蛋白的影响 ,了解其对维持性血液透析患者微炎症状态的作用 ,探讨他汀类药物在透析患者中应用指征。方法 :将 34例稳定维持血液透析患者 ,随机分为实验组 1 9例及对照组 1 5例。实验期间实验组每位患者每日服用舒降之 2 0mg ,对照组不服药 ,时间为 2月 ,分别在实验开始、1月末、2月末检测患者血IL - 6、CRP、前白蛋白、转铁蛋白及血脂浓度。实验结果采用t检验分析。结果 :和实验前相比 ,实验结束时实验组IL - 6明显升高、CRP明显降低、白蛋白与转铁蛋白升高 ,均具有统计学差异 (P <0 .0 1 ) ;而前白蛋白虽有一定幅度上升 ,但结果无统计学差异。实验前后 ,总胆固醇、LDL浓度改变未显示出统计学差异。而实验结束时甘油三酯较 1月末及实验开始时显著降低 ,结果具有统计学差异。对照组各项指标试验前后无明显改变。结论 :舒降之可降低维持性血液透析患者血液CRP、IL - 6浓度 ,升高转铁蛋白、白蛋白浓度 ,改善患者营养及微炎症状态 ,这种作用并不依赖于其调脂功能。
Objective:To study the changes of IL-6,CRP,albumin, prealbumin and transferrin serum level in maintenance hemodialysis patients after taking 20 mg simvastatin per day for 2 months and the effects of simvastatin on microinflammatory state.Methods:Thirty-four stable maintenance hemodialysis patients in our dialysis center were enrolled. Mean dialysis time was 46.3 months and the mean age was 56.8. Patients were randomly divided into simvastatin group (11 males and 8 females)and control group(9 males and 6 females). Patients in simvastatin group took simvastatin 20 mg per day for 2 months while patients in control group took no medicines.IL-6,CRP,albumin,prealbumin and transferrin were measured at the baseline, 1 month and 2 month.T-test was used to analyze the results.Results:The IL-6(16.1±5.2 vs 8.6±5.8 pg/ml, P <0.01),CRP(5.1±4.2 vs 3.3±2.6 mg/l, P <0.01), albumin(3.12±0.25 vs 3.31±0.35 g/dl, P <0.01) and serum transferrin (1.9±0.5 vs 2.3±0.5 g/l, P <0.01) level significantly improved in simvastatin group, while there was no significant difference in serum level of prealbumin(0.40±0.09 vs 0.41±0.09g/L, P >0.05).TG was significantly reduced after 2 months, but TC and LDL remained unchanged.All the markers in the control group did not change throughout the trial.Conclusion:Simvastatin can reduce serum levels of IL-6,CRP and increase albumin and transferrin levels and can improve the microinflammatory state in maintenance hemodialysis patients independent of its lipid-lowering property.
出处
《中国中西医结合肾病杂志》
2004年第9期515-518,共4页
Chinese Journal of Integrated Traditional and Western Nephrology
基金
温州医学院附属第一医院基金资助项目 (No .2 0 0 2 12 )
