不同剂量阿托伐他汀对老年早期糖尿病肾病患者外周血NF-κB活性和尿白蛋白排泄率的影响

目的：观察不同剂量阿托伐他汀对老年早期糖尿病肾病（DN）患者外周血单个核细胞中核因子-κB（NF-κB）P65（ser536）的磷酸化水平、血清炎症因子水平（hs-CRP、TNF-α、IL-6、IL-1β）及尿白蛋白排泄率（UAER）的影响。方法将72例2型糖尿病早期DN老年患者，半随机分为两组，分别给予阿托伐他汀钙片10mg/d（DN1组，37例）和20mg/d（DN2组，35例），疗程16周。测定两组患者治疗前和治疗16周后外周血NF-κBP65的磷酸化水平、血清炎症因子水平、UAEA、血脂（TC、TG、DHL-C、LDL-C）。结果两组患者治疗后外周血NF-κBP65水平、血清炎症因子水平、TC及LDL-C均较治疗前降低（P＜0.01或P＜0.05），以DN2组降低更显著。DN2组治疗后UAER较治疗前显著降低（P＜0.01），DN1组无显著下降（P＞0.05）。结论阿托伐他汀在降低血脂的同时可降低外周血NF-κBP65的活性、血清炎症因子hs-CRP、TNF-α、IL-6、IL-1β水平，改善患者炎症状态，减少尿蛋白，且呈剂量依赖性。

Effects of different doses of atorvastatin on the activity of nuclear factor-kappa B in peripheral blood mono-nuclear cells and urinary albumin excretion rate in the elderly patients with early diabetic nephropathy

Objective To observe the effects of different doses of atorvastatin on phosphorylation of nuclear factor-kappa B（NF-κB） P65（ser536） in peripheral blood mononuclear cells , on the levels of serum inflammatory factors,including high sensitivity C reactive protein （hs-CRP）,tumor necrosis factor-α（TNF-α）,interleukin-6（IL-6 ）,interleukin-1β（IL1-β）, and on urinary albumin excretion rate（UAER） in the elderly patients with early diabetic nephropathy.Methods The patients（n=72） of type 2 diabetes with early nephropathy were randomly divided into two groups ,The patients were given atorvastatin 10 mg/d in DN1 group and atorvastatin 20 mg/d in DN2 group for sixteen weeks.Levels of NF-κB, serum inflammation factors,UAER,Total cholesterol（TC）,triglyceride（ TG）,low density lipoprotein （ LDL-C） and hight density lipoprotein （ HDL-C） were measured before treatment and after treat-ment for sixteen weeks .Results After sixteen weeks of treatment ,the levels of NF -kB, serum inflammation factors , TC and LDL were reduced（P〈0.05 or P〈0.01） in two group.DN2 group decreased more significantly.UAER were reduced（P〈0.01）in DN2 group.There was no significant changes in DN1 group（P〉0.05）.Conclusion Atorvastatin can reduce activity of NF-κB, levels of hs-CRP,TNF-α,IL-6,IL-1β,TC, and LDL in the olderly patients with type 2 diabetic pristine nephropathy .Atorvastatin may benefit patients with diabetes mellitus by ameliorating in-flammatory stats, as well as reducing urinary albumin ,in a dose-dependent manner .