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目的探讨强化洛伐他汀治疗对早期慢性肾脏病(CKDI-II)合并冠心病患者肾功能的影响。方法选择2007年1月-2009年1月西丽人民医院就诊早期慢性肾脏病合并冠心病患者62例并随机分为治疗组和对照组。对照组给予常规治疗及洛伐他汀20 mg/d,强化治疗组在上述治疗的基础上将洛伐他汀加至40 mg/d。每3个月比较两组患者血压、血总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、甘油三酯(TG)、尿蛋白定量(Upr)、血肌酐(Scr)、C反应蛋白(CRP)、肝功能等指标。结果两组治疗后较治疗前TC、TG、LDL-C均明显下降,治疗前后差异有统计学意义(P<0.05,P<0.01),但组间无显著差异,HDL-C略上升,但差异无统计学意义(P>0.5)。两组治疗后Upr和Scr均明显下降(P<0.05),强化治疗组Upr和Scr下降比对照组明显(P<0.05,P<0.01)。结论强化洛伐他汀在治疗慢性肾脏病合并冠心病中应用安全,能够更好地保护肾功能。
Objective To investigate the effects of intensive lovastatin on renal function in patients with early CKD-II complicated with coronary heart disease. Methods Sixty-two patients with early-stage chronic kidney disease and coronary heart disease in Xili People’s Hospital from January 2007 to January 2009 were selected and randomly divided into treatment group and control group. The control group was given routine treatment and lovastatin 20 mg / d. The intensive treatment group added lovastatin to 40 mg / d on the basis of the above treatment. Blood pressure, blood total cholesterol (TC), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C), triglyceride (TG), urine protein (Upr) , Serum creatinine (Scr), C-reactive protein (CRP), liver function and other indicators. Results The levels of TC, TG and LDL-C in both groups after treatment were significantly lower than those before treatment, with significant difference between before and after treatment (P <0.05, P <0.01), but there was no significant difference between the two groups and HDL-C slightly increased The difference was not statistically significant (P> 0.5). The Upr and Scr of both groups decreased significantly (P <0.05), and the levels of Upr and Scr decreased in the intensive treatment group compared with the control group (P <0.05, P <0.01). Conclusion Lovastatin enhanced in the treatment of chronic kidney disease with coronary heart disease in the application of safety, can better protect renal function.