| The first part: CKD contact high cholesterol,micro inflammation,oxidative stressObjective:Study of dialysis patients with chronic kidney disease(CKD)2-5 for dyslipidemia and the inflammatory state,the connection between the oxidative stress reaction,and with the decline in renal function,body state of micro inflammation and oxidative stress reaction is increased.Method:From 2014.9 to 2016.5 was in the hospital or outpatient,physical examination center patients as the research object,by the method of queue and setting the inclusion criteria and exclusion criteria.select the non-dialysis CKD(2-5)combination of 78 patients with hyperlipemia(CKD2-5 12,28,26,12 cases),not with hyperlipemia in patients with CKD,60 cases(CKD2-5 10,20,18,12);The other selected patients with hyperlipemia(20)and normal person(20)as control group;All the blood specimen determination of blood fat,liver and kidney function,blood routine,TNF-?,IL-6,MDA,SOD.Results: 1.Inflammation factors(TNF-a,IL-6),the expression of case: the pure hyperlipemia group,CKD is not associated with hyperlipemia,CKD with hyperlipemia group were significantly higher than that of normal people(P < 0.05);CKD is not associated with hyperlipemia group stage 3 is significantly higher than 2(P < 0.05),4 period is significantly higher than 3 period(P < 0.05),no obvious difference between the stage 5 and 4(P > 0.05);CKD with hyperlipemia group was significantly higher than the pure hyperlipemia,CKD is not associated with hyperlipemia group(P < 0.05),and CKD with hyperlipemia group stage 3 is significantly higher than 2(P < 0.05),4 period is significantly higher than 3 period(P < 0.05),no obvious difference between the stage 5 and 4(P > 0.05).2.Oxidative stress indicators(MDA,SOD)expression in: 2.1 MDA expression: in pure hhyperlipemia group,CKD is not associated with hyperlipemia,CKD with hyperlipemia group were significantly higher than that of normal people(P < 0.05);CKD is not associated with hyperlipemia group stage 3 is significantly higher than 2(P < 0.05),4 period is significantly higher than 3 period(P < 0.05);CKD with hhyperlipemia group was significantly higher than the pure hyperlipemia,CKD is not associated with hyperlipemia group(P < 0.05),and CKD with hyperlipemia group stage 3 is significantly higher than 2(P < 0.05),4 period is significantly higher than 3 period(P < 0.05),no obvious difference between the stage 5 and 4(P > 0.05).2.2 SOD expression: in pure hyperlipemia group,CKD is not associated with hyperlipemia,CKD with hyperlipemia group were significantly lower than that of normal people(P < 0.05);CKD is not associated with hyperlipemia group stage 3 significantly below 2(P < 0.05),4 period was significantly lower than 3 period(P < 0.05),no obvious difference between the stage 5 and 4(P > 0.05);CKD with hyperlipemia group was significantly lower than hyperlipemia,CKD is not associated with hyperlipemia group(P < 0.05),and CKD stage with hyperlipemia group 3 was significantly lower than 2(P < 0.05),4 period was significantly lower than 3 period(P < 0.05),no obvious difference between the stage 5 and 4(P > 0.05).3.Cholesterol levels and inflammation factors(TNF-a,IL-6)positively correlated,and oxidative stress indicators(MDA)were positively correlated,and negatively correlated with antioxidant index(SOD).Conclusion: 1.Pure hyperlipemia patients state of micro inflammation and oxidative stress is higher than normal person,and cholesterol levels and micro inflammation in the body and related to oxidative stress response,high cholesterol,may cause the body appear inflammation and oxidative stress response;2.The dis-dialysis CKD2-5 stage patients have inflammation and oxidative stress,and as the kidney function decline,micro inflammation and oxidative stress is on the rise;3.The merger of hypercholesterolemia in patients with CKD micro inflammation and oxidative stress in the body is higher than the hypercholesterolemia not in patients with CKD,hypercholesterolemia may participate in the development of CKD.The second part: Atorvastatin cholesterol-lowering,anti-inflammatory,antioxidant effect researchObjective: Observation of atorvastatin on non dialysis patients with stage 2-4 CKD cholesterol-lowering effect and the curative effect of inflammation,explore atorvastatin in CKD associated with dyslipidemia micro inflammation resistance,oxidation resistance,delay the deterioration of renal function,Methods: To between 2014.9 to 2016.5 our department in hospital or outpatient CKD associated with hyperlipidemia,physical examination center pure hyperlipidemia patients as the research object.hyperlipidemia group for hyperlipidemia patients take atorvastatin(20 mg qd),a total of 10 cases;Control group in patients with hyperlipidemia CKD3-4 period with not taking atorvastatin,a total of 24 cases(CKD3-4 13,11),drug group was selected with hyperlipidemia CKD3-4 patients take atorvastatin(20 mg qd),a total of 26 patients(CKD3-4 14,12 cases),respectively in the experiments before and after taking atorvastatin 2,4,8,12 weeks,the determination of blood collected TC,LDL-C,taking before and used in the determination of atorvastatin after 12 weeks of serum creatinine,TNF alpha,IL-6,MDA,SOD.Results: 1.The changes of blood lipid(TC,LDL-C)1.1 before the trial,blood fat have no obvious difference between the three groups;Control group stage 3,4,each time point of hematic fat no significant change(P > 0.05);1.2 hyperlipidemia group of blood lipids(TC,LDL-C)2 w began to decline,4 w drop to normal;2 w blood lipids in the control group is lower than control group stage 3,4,but no statistical difference(P > 0.05);4 w and 8 w,12 w as the hyperlipidemia group of lipid than control group stage 3,4,lower blood lipids,statistically significant(P < 0.05);1.3 Drug group of lipid(TC,LDL-C)2 w began to decline,4 w drop to normal;2 w drug group 3 phase of the blood lipid,lower than the control group 3 period?4 period is higher than hyperlipidemia group,but no statistical difference(P > 0.05),4 w and 8 w,12 w 3 period?4 period of lipid drug group were lower than the control group,higher than the hyperlipidemia group,there are statistically significant(P < 0.05);Drug group with the increase of installment,lipid-lowering efficacy,drug group of each time point lipid 4 higher than stage 3,but no statistical difference(P > 0.05).2.Inflammation factors(TNF-a,IL-6): Before the trial,inflammation of the drug group and the control group factor concentration has no obvious difference(P > 0.05),after 12 weeks,control group no significant change in the inflammation factor of every period,inflammation of the drug group 3 phase factor than the control group 3 period decreased significantly,the drug group stage 4 of inflammatory factor than the control group 4 decreased significantly(P < 0.05);Hyperlipidemia group after 12 weeks of inflammatory factors than before the trial decreased significantly(P < 0.05).3.Oxidative stress indicators(SOD,MDA): 3.1 the expression of SOD: before the trial,the drug group and the control group of SOD has no obvious difference(P > 0.05),after 12 weeks,control group no significant change in the SOD of every period,drug group 3 period of SOD significantly increased than the control group 3 period,drug group stage 4 of SOD than control group 4 significantly increased(P < 0.05);The hyperlipidemia group after 12 weeks of SOD was significantly greater than the experimental group(P < 0.05).3.2 the expression of MDA: before the trial,the drug group and the control group MDA concentration has no obvious difference(P > 0.05),after 12 weeks,no significant change in control group,the MDA of every period,drug group 3 period of MDA than blank group 3 period dropped significantly,drug group stage 4 of the MDA than control group 4 decreased significantly(P < 0.05);The hyperlipidemia group after 12 weeks of MDA than before the trial decreased significantly(P < 0.05).4.The change of the TC level is closely related to the TNF-a,IL-6(P < 0.05),were negatively correlated.5.Before the trial,drug group and the control group of serum creatinine no statistical difference(P > 0.05);After 12 weeks,two groups of s Cr no statistical difference(P > 0.05),serum creatinine than before but the drug group slightly downward trend.Conclusion: 1.Atorvastatin can reduce hypercholesterolemia patients state of micro inflammation,oxidative stress,in patients with CKD,also have anti-inflammatory,antioxidant effect,this may be one of mechanisms of statins protect kidney;2.In patients with CKD,atorvastatin cholesterol-lowering effect is abate,and,as the deterioration of renal function,the extent of atorvastatin cholesterol-lowering fell,may be associated with micro inflammation in the body state for patients with CKD;3.Atorvastatin can slightly reduce serum creatinine in patients with CKD,but without statistical significance. |
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