老年早期糖尿病肾病患者血清炎症因子、外周血NFκ-B活性变化及阿托伐他汀的治疗作用

目的观察老年早期糖尿病肾病（DN）患者血清炎症因子水平、外周血NF-κB活性的变化,并探讨阿托伐他汀对DN患者的治疗作用。方法根据是否合并DN将96例2型糖尿病患者分为糖尿病（DM）组30例、DN组66例。DN组随机分为DM常规治疗组（DN1组）31例、DM常规治疗＋阿托伐他汀治疗组（DN2组）35例,并选择30例健康体检者作为对照组（NC组）。分别观察各组患者高敏C反应蛋白（hs-CRP）、TNF-α、IL-6、IL-1β及外周血NF-κB p65的磷酸化水平。结果 NC组、DM组、DN组血清hs-CRP、TNF-α、IL-6、IL-1β水平及外周血NF-κBp65活性逐渐升高（P〈0.01或〈0.05）。阿托伐他汀治疗后NF-κB p65活性及hs-CRP、TNF-α、IL-6、IL-1β明显下降（P〈0.01或〈0.05）。结论阿托伐他汀可抑制老年早期DN患者外周血NF-κB p65的活性,并可降低血清hs-CRP、TNF-α、IL-6、IL-1β等炎症因子的水平,显著改善患者炎症状态。

Changes of serum proinflammatory factors and peripheral blood NF-κB activity in elderly diabetics with early nephropathy and treatment effect of Atorvastatin

Objective To observe the changes of serum proinflammatory factors and peripheral blood NF-κB activity in elderly diabetics with early nephropathy,and study the treatment effect of Atorvastatin.Methods Ninety-six patients with T2DM,according to whether the merger DN divided into DM group（n=30）,DN group（n=66）.DN group randomly divided into DM conventional treatment group（DN1 group,n=31）,DM conventional therapy ＋ Atorvastatin treatment group（DN2 group,n=35）,and choosing 30 cases of healthy check-up persons as control group（NC group）.Observing serum proinflammatory factors respectively with hypersensitive C-reactive protein（hs-CRP）,TNF-α,IL-6,IL-1β and peripheral blood NF-κB p65 of phosphorylation level.Results In NC group,DM group,DN group,serum proinflammatory factors hs-CRP,TNF-α,IL-6,IL-1β level and peripheral blood NF-κB p65 activity were increasing gradually（P0.01 or0.05）.After treatment of Atorvastation,NF-κB p65 activity and proinflammatory factors hs-CRP,TNF-α,IL-6,IL-1β descended obviously（P0.01 or0.05）.Conclusions Atorvastatin inhibits peripheral blood NF-κB p65 activity in elderly early DN patients,and could reduce serum proinflammatory factors hs-CRP,TNF-α,IL-6,IL-1β levels,and improve inflammatory condition.