氟伐他汀、辛伐他汀治疗肾病时肝功能损害的比较研究

目的 观察两种他汀类药物治疗肾病综合征高脂血症时肝脏功能损害情况。为临床治疗选择较为合适的他汀类药物提供依据。方法 将118例肾病综合征高脂血症患者随机分为3组，3组均行标准剂量激素和一般对症治疗，A组同时使用氟伐他汀。B组同时使用辛伐他汀，C组不用任何降脂药物。观察使用他汀类药物前后各组患者肝功能的变化。结果 A组患者转氨酶变化与对照组比较差异无统计学意义（P〉0．05）。B组转氨酶在用药后短期内升高。与A组、C组及自身用药之前比较，差异具有统计学意义（P〈0．01）。结论 两种他汀类药物治疗肾病综合征高脂血症时，氟伐他汀肝脏功能损害轻于辛伐他汀。可优先选择。

Study of hepatic injury of HMG-CoA reductase inhibitors-simvastatin and fluvastatin in treating nephrotic syndrome

Objective To observe the degree of hepatic injury of hydroxymethylglutaryl coenzyme A (HMG CoA) reductase inhibitors-simvastatin and fluvastatin in treating hyperlipemia of patients with nephrotic syndrome. And to select suitable hydroxymethylglutaryl coenzyme A (HMG CoA) reductase inhibitors for clinic treatments. Methods 118 cases of patients with nephrotic syndrome accompanied by hyperlipemia were divided into 3 groups randomly. Each group was treated with standard dosage glucocorticosteroid and common symptomatic treatments. Simultaneously, group A, group B and group C were treated with fluvastatin, simvastatin and no other drugs respectively. The change of hepatic function was compared after medication. Results There is no significant difference on the change of aminopherase between group A and group C. But the change of aminopherase in group B increased during short periods and there is significant statistical difference compared to group A, group C and untreated group B. Conclusion Fluvastatin can be selected first because of its light hepatic injury, when using simvastatin and fluvastatin to treat hyperlipemia with nephrotic syndrome.