氟伐他汀对维持性血液透析患者氧化应激及非对称性二甲基精氨酸的影响

目的观察口服氟伐他汀对维持性血液透析（MHD）患者氧化应激状态和非对称二甲基精氨酸（asymmetric dimethylarginine，ADMA）及颈动脉粥样硬化斑块的影响。方法选择透析时间超过6个月的MHD患者64例，分为治疗组36例和对照组28例，治疗组口服氟伐他汀（40mg，1次／d）治疗；对照组不用氟伐他汀。进行为期6个月随访，分别检测治疗前、治疗后6个月末患者的ADMA、血总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、超敏C反应蛋白（hs-CRP）、白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）、丙二醛（MDA）。结果治疗后6个月末，2组HDL-C均较治疗前明显升高（P〈0．05），TC、TG、LDL-C较治疗前明显降低（P〈0．05），且CRP、IL-6、TNF-α、MDA和ADMA较治疗前明显降低（P〈0．05）。结论氟伐他汀可明显改善MHD患者的血脂水平，同时可改善患者氧化应激状态和降低ADMA的水平。

Effects of fluvastation on oxidative stress and serum asymmetric dimethylarginine levels in maintenance hemodialysis patients

Objective To investigate the effects of fluvastation on oxidative stress and asymmetric dimethylarginine（ADMA） levels and carotid atherosclerotic plaque in maintenance hemodialysis （MHD） patients. Methods Sixty-two MHD patients were selected, who had undergone hemodialysis for at least six months before the study and were in a stable clinic status without signs of infection or disease activity. All MHD patients were randomly divided into two groups： treatment group （n = 36）, and control group（n = 28）. In the treatment group, 40 nag of fluvastation was taken orally once each day for six months. The serum levels of ADMA, C-reactive protein （CRP）, interlukin-6 （IL-6）, total cholesterol（TC）, triglyceride（TG）, high density lipoprotein cholesterol（HDL-C）, low density lipoprorein cholesterol（LDL-C）, tumor necrosis factor alpha （TNF-α）, and serum malondialdehyde （MDA） were determined before and after the treatment. Results After treatment with fluvastation for six months, the average levels of HDL-C were increased（P〈0. 05） ,while the levels of TC,TG and LDL- C decreased markedly（P〈0. 05）. The average serum levels of hs-CRP, IL-6, TNF-α, SOD, MDA and ADMA were significantly lower than those of baseline（P〈0. 05）. Conclusion Fluvastatin can significantly improve serum lipid metabolism, alleviate the microinflammation and reduce serum-ADMA levels in patients with MHD.