辛伐他汀联合阿司匹林对糖尿病肾微血管病变患者炎症因子的影响

目的 探讨糖尿病肾微血管病变患者血清P-选择素、肿瘤坏死因子-α(TNF-α)、高敏C-反应蛋白(hs-CRP)、白介素-1β(IL-1β)、细胞间粘附分子(ICAM)的临床意义及辛伐他汀联合阿司匹林治疗糖尿病肾微血管病变的机制.方法 用ELISA法测定各组以及糖尿病肾微血管病变组患者用辛伐他汀联合阿司匹林治疗后上述血清因子的变化水平.结果 ①糖尿病各组血清P-选择素、TNF-α、hs-CRP、IL-1β、ICAM均高于正常对照组(均P<0.01).②P-选择素、TNF-α、hs-CRP、IL-1β、ICAM在治疗8周时与治疗前比较均有明显下降(均P<0.05),治疗16周时进一步下降(P<0.01),以后保持稳定至21周.结论 ①P-选择素、TNF-α、hs-CRP、IL-1β、ICAM参与糖尿病肾微血管病变的发生发展,是糖尿病肾微血管病变的早期预测因子;②辛伐他汀联合阿司匹林治疗糖尿病肾微血管病变的机制可能是通过抑制炎症因子的表达,直接或间接影响系膜细胞增殖和系膜基质增生.

Simvastatin in combination with aspirinon for diabetic renal microangipathy in patients with inflammation factor

Objective To investigate the clinical significance of serum P-selection,TNF-α,hs-CRP,IL-1β, ICAM in patients with diabetic renal microangipathy, and the therapeutic mechanism of Simvastatin combined with aspirinon in treating renal microangipathy. Methods The serum levels of P-selection,TNF-α, hs-CRP, IL-1β, ICAM were determined by ELISA in all groups. Patients with diabetic renal microangipathy treated with simvastatin and as-pirinon. Results ① The serum levels of P-selection,TNF-α,hs-CRP,IL-1β,ICAM in DM groups were higher than those of normal controls(P<0.01). ②After treatment with simvastatin and aspirinon for 8 weeks in patients with di-abetic nephropathy,the serum levels of P-selection, TNF-α, hs-CRP, IL-1β, ICAM were all decreased significantly compared with those before treatment respectively (P<0.01). After treatment for 16 weeks the above indices re-mained decreased until treatment for 21 weeks (P<0.01). Conclusion ①The plasma levels of Poselection,TNF-α and hs-CRP, IL-1β, ICAM are correlated to the occurance and development of diabetic renal microangiopathy, becom-ing predicted factors in early stage of diabetic renal microangiopathy. ②The therapeutic mechanism of simvastatin and aspirinon in patients with diabetic nephropathy lies probably in the inhibition of these factors expression, thus di-rectly or indirectly affecting the prolffer-ation of mesangial cells and mesangial matrix.