阿托伐他汀联合丹参酮对慢性肾病患者白蛋白尿和血脂异常的影响

目的 评价阿托伐他汀和丹参酮联用对慢性肾病（CKD）患者肾功能和糖脂代谢参数的影响。方法 前瞻性纳入伴有白蛋白尿和血脂异常非透析性CKD患者90例，随机分为观察组（n=45）和对照组（n=45）。在CKD标准化治疗的基础上，对照组给予丹参酮ⅡA磺酸钠注射液；观察组加用阿托伐他汀钙片10 mg/d。两组疗程均为6个月。比较两组患者治疗前后的糖脂代谢功能及肝肾功能。结果 治疗半年后，两组患者的总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）均下降，高密度脂蛋白胆固醇（HDL-C）增加，同组治疗前后比较差异有统计学意义（P<0.05）；且观察组患者的TC、TG、LDL-C显著低于对照组，HDL-C显著高于对照组，组间差异有统计学意义（P<0.05）。所有患者对阿托伐他汀均耐受，两组患者的天门冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）及肌酸激酶（CK）均无显著性差异。观察组和对照组患者的肾小球滤过率（eGFR）和高尿白蛋白肌酐比（UACR）无统计学差异。结论 他汀类药物联合丹参酮改善了CKD患者的血脂异常状态，表现出一定的肾脏保护作用。

Effects of Atorvastatin combined with Tanshinone on chronic kidney disease with albuminuria and dyslipidemia

Objective The purpose of the present study was to examine possible therapeutic effects of statin combined with Tanshinone on renal function as well as parameters of lipid and glucose metabolism.Methods Ninety non-dialysis CKD Patients with albuminuria and dyslipidemia were prospectively enroled, and were randomly divided into observation group (n=45) and control group (n=45). Patients in the observation group were treated with Atorvastatin (10 mg/d) combined with Tanshinone, while patients in the control group were treated with Tanshinone only. We compared indexes of glucolipids metabolism and hepatorenal function between the two groups before therapy and six months after therapy.Results After six months treatment, the levels of TC, TG and LDL-C were decreased and HDL-C were increased in the two groups. The levels of TC, TG and LDL-C in the observation group were significantly lower than in the control group (P < 0.05). All patients were tolerant to atorvastatin. There was no significant difference in ALT, AST and creatine kinase between the two groups. There was no significant difference in eGFR and UACR between the two groups.Conclusions Statins combined with tanshinone improves dyslipidemia in CKD patients,which show a certain degree of renal protection.