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目的：观察血清胱抑素C(Cystatin C，Cys C)在阿托伐他汀治疗早期心肾综合征中的变化，探讨Cys C在阿托伐他汀治疗早期心肾综合征中的临床意义。方法：选择90 例慢性心功能不全引起的早期心肾综合征患者，随机分为常规治疗组（A 组）、阿托伐他汀20 mg组（B 组）以及阿托伐他汀40 mg组（C 组）各30 例。常规治疗组给予常规抗心力衰竭药物治疗，阿托伐他汀组在常规抗心衰药物治疗基础上分别加用阿托伐他汀20 mg/d 或者阿托伐他汀40 mg/d 口服。分别测定其治疗3 个月前后Scr、GFR、Cys C 水平并进行组间比较。结果：治疗3 个月后，A 组、B 组Scr及GFR 分别与治疗前比较差异无显著性（P>0.05），C 组Scr 及GFR 与治疗前比较差异有显著性（P<0.05）；治疗3 个月后，A 组CysC 与治疗前比较差异无显著性（P>0.05），B 组、C组CysC 与治疗前比较差异有显著性（P<0.01）。结论：在阿托伐他汀治疗早期心肾综合征疗效观察中，CysC 较Scr 更能敏感反应早期肾功能变化情况。

英文摘要:

Objective:To investigate the change of serum Cystatin C (CysC) in early cardiorenal syndrome treated with atorvastatin and its clinical significance.Methods:90 patients with chronic heart failure caused by early cardiorenal syndrome were randomly divided into conventional treatment group (group A, n = 30), atorvastatin 20 mg group (group B, n = 30) and atorvastatin 40 mg group (group C, n = 30). The conventional treatment group received conventional anti-heart failure drug therapy, atorvastatin group was treated with atorvastatin 20 mg/d or atorvastatin 40 mg/d orally on a regular basis. The level of Scr, GFR, CysC was observed before treatment and 3 months after treatment.Results:The level of Scr and GFR in group A and B after 3 months of treatment had no difference compared with before treatment (P> 0.05); but in group C, Scr and GFR showed difference after treatment with statistical significance (P <0.05); after 3 months of treatment, CysC level in group A had no significant difference compared with before treatment (P> 0.05), while it showed a significant difference in group B and group C compared with before treatment (P <0.01).Conclusion:CysC is more sensitive to early change of renal function than Scr in the curative observation of early cardiorenal syndrome treated with atorvastatin.

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