羥苯磺酸鈣對糖尿病腎病3期患者hs—CRP、TNF—α的影響
發(fā)布時間:2018-06-23 來源: 歷史回眸 點擊:
【摘要】 目的:探討羥苯磺酸鈣對糖尿病腎病(diabetic kidney disease,DKD)3期患者體內炎性因子hs-CRP、TNF-α的影響及對腎臟的保護作用。方法:選擇本院2014年1月-2017年6月期間尿白蛋白肌酐比值(albumin to creatinie ratio,ACR)30~300 μg/mg的DKD3期患者30例,按照隨機數表法分為羥苯磺酸鈣治療組和DKD對照組,每組各15例。另外選擇健康體檢的正常人群15例作為健康對照組。檢測三組患者的糖化血紅蛋白、尿ACR、hs-CRP、α腫瘤壞死因子(tumor necrosis factor-α,TNF-α),治療6個月后重復測定上述指標。結果:DKD3期患者hs-CRP、TNF-α水平顯著高于健康對照組(P<0.05),經羥苯磺酸鈣治療6個月后,羥苯磺酸鈣治療組ACR、hs-CRP、TNF-α水平較DKD對照組明顯下降(P<0.05)。結論:在控制血壓、血糖在相同水平的基礎上,羥苯磺酸鈣可通過減少炎癥因子,減輕炎癥反應,減少尿蛋白的排泄從而延緩DKD3期的進展,保護腎臟。
【關鍵詞】 羥苯磺酸鈣; 超敏C反應蛋白; α腫瘤壞死因子; 糖尿病腎病
The Effects of Calcium Dobesilate on Serum hs-CRP and TNF-α in Patients with 3rd Stage of Diabetic Kidney Disease/JIA Miao,XIE Yuxian,QIU Hong.//Medical Innovation of China,2018,15(07):005-008
【Abstract】 Objective:To explore the protective effect of calcium dobesilate on serum hs-CRP and TNF-α in patients with 3rd stage of diabetic kidney disease(DKD).Method:A total of 30 cases with 3rd stage of DKD in our hospital from January 2014 to June 2017 were randomly divided into Calcium Dobesilate group and DKD group according to table of random numbers,15 cases in each group.15 healthy volunteers were selected with same age,gender ratio as healthy control group.The levels of serum HbA1c,urinary ACR,hs-CRP,TNF-α of three groups were repeatedly measured after 6 months.Result:The levels of hs-CRP and TNF-α in 3rd stage of DKD were higher than those in healthy control group(P<0.05).After the treatment of Calcium Dobesilate for 6 months,the levels of urinary ACR,hs-CRP and TNF-αin Calcium Dobesilate group were significantly decreased than those in DKD group(P<0.05).Conclusion:Calcium Dobesilate might delay the development of 3rd stage of DKD and protect kidney through suppressing inflammation,reducing inflammatory factor and urinary protein excretion on the basis of the same values in blood pressure and blood glucose.
【Key words】 Calcium Dobesilate; hs-CRP; TNF-α ; Diabetic kidney disease
First-author’s address:The People’s Hospital of SND,Suzhou 215129,China
doi:10.3969/j.issn.1674-4985.2018.07.002
糖尿病腎病(diabetic kidney disease,DKD)是糖尿病的重要微血管并發(fā)癥,是目前導致終末期腎臟病的主要原因。臨床尚無針對性的藥物能有效延緩其進展,目前常規(guī)采用降糖、血管緊張素轉換酶抑制劑(angiotensin-converting enzyme inhibitors,ACEI)或血管緊張素受體阻滯劑(angiotensin receptor blocker,ARB)類藥物改善腎小球的血流動力學等方法,但仍無法阻斷DKD的進展。羥苯磺酸鈣是一種微血管保護劑,是目前公認較理想治療微血管病變的藥物。近年研究提示炎癥反應參與DKD的發(fā)生發(fā)展,DKD3期即微量蛋白尿期是DKD從隱性轉向顯性的關鍵階段,對這個階段的干預對于遏制DKD發(fā)展至大量蛋白尿期具有重要意義。本文旨在探討通過羥苯磺酸鈣減輕DKD炎癥反應是否可產生腎臟保護作用,現報道如下。
1 資料與方法
1.1 一般資料 選擇本院2014年1月-2017年6月期間尿白蛋白肌酐比值(Urinary albumin/creatinine ratio,ACR)30~300 μg/mg的DKD3期患者30例,按照隨機數字表法分為羥苯磺酸鈣治療組和DKD對照組,每組各15例。另外選取15例同年齡段、相同性別構成的醫(yī)院健康體檢患者為健康對照組。納入標準:(1)糖尿病診斷采用中國2型糖尿病防治指南(2010年版)標準;(2)眼底檢查有糖尿病視網膜病變;(3)同意使用胰島素強化血糖治療;(4)簽署患者知情同意書。DKD分期參考Mogensen的五期分類,DKD3期診斷標準:糖尿病史5~10年,持續(xù)性微量白蛋白尿,尿ACR 30~300 μg/mg,腎功能正常。排除標準:型糖尿病患者,已伴有糖尿病急性并發(fā)癥、發(fā)熱、自身免疫系統(tǒng)疾病、外傷性感染、原發(fā)性腎臟疾病或其他繼發(fā)性腎臟病、原發(fā)性高血壓、心肝腎功能不全及近期接受過手術治療的患者均排除在外。上述研究得到醫(yī)院倫理委員會批準。
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