瑞舒伐他汀钙在特发性膜性肾病降脂治疗中的效果分析-现代医学

瑞舒伐他汀钙在特发性膜性肾病降脂治疗中的效果分析

单位：徐州医科大学附属医院肾内科, 江苏徐州 221002

分类号：R692

出版年·卷·期（页码）：2017·36·第四期（567-571）

摘要：

目的：在特发性膜性肾病（IMN）常规治疗基础上上增加瑞舒伐他汀钙治疗，检测不同时间患者的生化指标，探讨瑞舒伐他汀钙降脂治疗中的效果。方法：选择115例已达肾病综合征诊断标准的原发性膜性肾病的病人。对照组55例予以醋酸泼尼松龙（GC）、环磷酰胺（CTX）、双嘧达莫、钙尔奇D、α-骨化醇及对症支持治疗，治疗组在对照组基础上加以瑞舒伐他汀钙10 mg每晚。观察疗程12周，分别记录治疗前、治疗4周末、8周末、12周末时患者生化指标及不良反应发生情况。结果：1.同一时间点两组间比较显示：总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）、脂蛋白a （LP （a））、纤维蛋白原（FIB）在治疗4周末两组之间差异已有统计学意义（P < 0.05），胱抑素C （CsyC）、载脂蛋白B （APOB）、白蛋白（ALB）、24小时尿蛋白定量（UTP）在治疗8周末两组之间差异已有统计学意义（P < 0.05），高密度脂蛋白（HDL）在治疗12周末两组之间差异有统计学意义（P < 0.05）。2.治疗前后组内比较显示：治疗组血肌酐（Scr）、TC、LP （a）、HDL、LDL、APOB、UTP、ALB、FIB在治疗4周末与治疗前相比差异已有统计学意义（P < 0.05），CsyC、TG在治疗8周末与治疗前相比差异有统计学意义（P < 0.05）；对照组Scr、UTP、ALB、HDL、FIB在治疗4周末与治疗前相比差异已有统计学意义（P < 0.05），LDL、LP （a）在治疗8周末与治疗前相比差异已有统计学意义（P < 0.05），TC、TG、APOB在治疗12周末与治疗前相比差异有统计学意义（P < 0.05）。3.治疗组转氨酶升高、横纹肌溶解、血栓栓塞等不良反应发生率低于对照组。结论：瑞舒伐他汀钙在特发性膜性肾病治疗中有比较显著的降脂作用，临床疗效显著且不良反应发生率低。

Objective: To observe the effect of atorvastatin calcium in the treatment of patients with nephrotic syndrome (NS). Methods: A retrospective analysis:Experiment on 115 cases of patients with primary nephrotic syndrome who were admitted to Xuzhou Medical University Affiliated Hospital in 2015.1-2016.6. The control group of 55 cases treated with prednisolone acetate (GC) and cyclophosphamide (CTX), dipyridamole D and symptomatic treatment. The experimental group are treated on the basis of the control group plus rosuvastatin calcium 10 mg per night (AstraZeneca). Observe the course of treatment for 3 months. Record the incidence of biochemical indicators and adverse reactions in 3 months pretherapy and post-treatment. Results: 1.At the same time point, the experiment shows that there are the some differences in total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), lipoprotein a (LP (a)), fibrinogen (FIB) 1、2 and 3 months later between the experimental group and the control group, The differences have statistical significance (P<0.05);There are some differences in Cystatin C (CsyC), apolipoprotein B (APOB), albumin (ALB), 24 hours urinary protein (UTP) in 2 and 3 months later after the treatment between the experimental group and the control group. The differences have also statistically significance (P< 0.05);There is a difference in high density lipoprotein (HDL) 3 months later posttreatment, the difference has statistical significance (P<0.05) between two groups.2.Shows in the same group at pretherapy and post-treatment:There are some differences in the serum creatinine (Scr), TC, LP (a), HDL, LDL, APOB, UTP, ALB, FIB after treating for 1、2 and 3 months later, the difference is statistical significant (P<0.05); The differences in CsyC and TG after the treatment of 2 and 3 months later have also statistical significance (P<0.05); Scr, UTP, ALB, HDL, FIB of the control group after treating 1、2、and 3 months are different from those of pretheraphy treatment, the differences are statistically significance (P<0.05); LDL, LP (a) after treatment 2、3 months are different from those before treatment, the differences are statistical significance(P<0.05); TC, TG, APOB after treating for 3 months later are different from those before treatment, the difference are statistical significance (P<0.05).3.Adverse reactions in the experimental group are lower than those in the control group. Conclusion: The effect of atorvastatin calcium in the treatment of idiopathic membranous nephropathy is significant, and the incidence of adverse reaction is low.

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