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目的 :观察辛伐地他汀 -舒降之对肾病综合征高脂血症的近期疗效及安全性 ,比较不同剂量辛伐他汀的降脂作用。方法 :72例均系肾综合并高脂血症的患者 ,随机分治疗组 (5 6例 )和对照组 (16例 ) ,在积极治疗原发病的同时 ,治疗组给予服辛伐他汀每晚 5～ 2 0mg ,14例混合性高脂血症患者同时服用非诺贝特 ;对照组未用降脂药。观察治疗前及治疗后 1周、2周血脂全套 (TC ,TG ,LDL和HDL)、肝功能 (AST ,ALT ,TP和ALB)、肾功能 (BUN ,Scr)、及尿蛋白定量的变化。结果 :辛伐他汀每晚 2 0mg服用 1周可使 6 3%的患者总胆固醇 (TC)下降 33% ,服用 2周可使 84%的患者血TC降至正常 ;单用辛伐他汀在降低TC的同时 ,可使甘油三酯 (TC)下降 43.16 % ,若与非诺贝特合用可使TG下降达 6 4.2 2 % ,未见不良反应发生 ;辛伐他汀的降脂作用与剂量及用药时间密切相关 ,2 0mg >10mg >5mg ,每晚服用 5mg共 2周仅能使 6 0 %的患者TC下降 12 .5 %。结论 :辛伐他汀 (每晚 2 0mg)能安全、快速有效降低肾病综合征患者的高脂血症 ,而对减少尿蛋白、改善肾功能近期无作用
Objective: To observe the effect and safety of simvastatin - sulindac on nephrotic syndrome with hyperlipidemia and to compare the lipid-lowering effect of simvastatin with different dosages. Methods: Seventy-two patients with renal syndrome and hyperlipidemia were randomly divided into treatment group (56 cases) and control group (16 cases). In the active treatment of primary disease, the treatment group was given simvastatin Night 5 ~ 20mg, 14 cases of mixed hyperlipidemia patients taking fenofibrate; control group did not use lipid-lowering drugs. The levels of TC, TG, LDL and HDL, liver function (AST, ALT, TP and ALB), renal function (BUN, Scr) and urinary protein were measured before treatment and 1 week and 2 weeks after treatment. RESULTS: Simvastatin 20 mg daily for 1 week reduced total cholesterol (TC) by 33% in 6 3% of patients and 84% of patients in 2 weeks reduced TC to normal. Simvastatin TC at the same time, triglycerides (TC) decreased 43.16%, if combined with fenofibrate TG can be down to 62.22%, no adverse reactions occurred; simvastatin lipid-lowering effect and dose and medication Time is closely related, 20mg> 10mg> 5mg, taking 5mg every night for a total of 2 weeks only 60% of patients with TC decreased by 12.5%. Conclusion: Simvastatin (20mg per night) can safely and quickly reduce hyperlipidemia in patients with nephrotic syndrome and has no immediate effect on reducing urinary protein and improving renal function