目的 觀察瑞舒伐他汀聯(lián)合門冬胰島素治療糖尿病腎病的臨床療效。方法 選取2015年4月—2016年12月在廣西壯族自治區(qū)第三人民醫(yī)院治療的糖尿病腎病患者68例，隨機分為對照組和治療組，每組各34例。對照組患者餐前30 min皮下注射門冬胰島素注射液，0.5～1.0 U/（kg·d），3次/d，根據(jù)患者具體情況調(diào)整劑量；或每日睡前皮下注射門冬胰島素注射液，起始劑量為6 U/d，根據(jù)次日晨起時血糖情況調(diào)整劑量。治療組在對照組的基礎(chǔ)上口服瑞舒伐他汀鈣片，20 mg/d。兩組患者均治療2周。觀察兩組患者臨床療效，比較治療前后兩組患者血糖水平、血脂水平和腎功能指標。結(jié)果 治療后，對照組和治療組的總有效率分別為70.6%、88.3%，兩組比較差異具有統(tǒng)計學意義（P<0.05）。治療后，兩組空腹血糖（FBG）、餐后2 h血糖（2 h PG）和糖化血紅蛋白（HbA1c）水平明顯降低，同組治療前后比較差異具有統(tǒng)計學意義（P<0.05）；且治療后治療組HbA1c水平明顯低于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。治療后，兩組總膽固醇（TC）、三酰甘油（TG）和低密度脂蛋白膽固醇（LDL-C）水平明顯降低，同組治療前后比較差異具有統(tǒng)計學意義（P<0.05）；且治療組TC、TG和LDL-C水平明顯低于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。治療后，兩組患者尿素氮（BUN）、血肌酐（Scr）和尿白蛋白排泄率（UAER）水平明顯降低，同組治療前后差異具有統(tǒng)計學意義（P<0.05）；且治療后治療組BUN、Scr和UAER水平明顯低于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。結(jié)論 瑞舒伐他汀聯(lián)合胰島素強化治療糖尿病腎病可有效調(diào)節(jié)患者血脂、血糖水平，改善腎功能狀況且安全性高。

Objective To analyze the clinical efficacy of rosuvastatin combined with insulin aspart in treatment of diabetic nephropathy. Methods Patients (68 cases) with diabetic nephropathy in the Third People's Hospital of Guangxi Zhuang Autonomous Region from April 2015 to December 2016 were randomly divided into control and treatment groups, and each group had 34 cases. Patients in the control group were subcutaneous injection administered with Insulin Aspart Injection 30 min before meal, 0.5-1.0 U/(kg·d), three times daily, and adjusted the dose according to the patient's specific condition, or they were iv subcutaneous injection administered with Insulin Aspart Injection before retiring, the initial dose was 6 U/d, and adjusted the dose according to the morning blood sugar. Patients in the treatment group were po administered with Rosuvastatin Calcium Tablets on the basis of the control group, 20 mg/d. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the blood glucose, blood lipid and renal function indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 70.6% and 88.3%, respectively, and there were differences between two groups (P < 0.05). After treatment, the FBG, 2 h PG, and HbA1c levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the HbA1c level in the treatment group was obviously lower than that in the control group, with significant difference between two groups (P < 0.05). After treatment, the TC, TG and LDL-C levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the TC, TG and LDL-C levels in the treatment group were more significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the BUN, Scr and UAER levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the BUN, Scr and UAER levels in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Rosuvastatin combined with insulin can effectively regulate blood lipids and blood glucose levels in treatment of diabetic nephropathy, and improve renal function with high safety.