糖脉康联合氯沙坦对早期糖尿病肾病微量白蛋白尿及氧化应激的影响(1)
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【摘要】 目的 探讨糖脉康联合氯沙坦对早期糖尿病肾病的微量白蛋白尿和氧化应激(oxidativestress,OS)的影响。方法 将67例早期2型糖尿病肾病患者分为两组,即氯沙坦组(n=34)及联合用药组(n=33),测定两组处理前后的氧化应激标志物丙二醛(maleicdialdehyde,MDA),超氧化物歧化酶(superoxidedismutase,SOD)和微量白蛋白尿水平。结果 治疗3个月后,氯沙坦组MDA和尿微量白蛋白水平明显下降(P<0.01),SOD活性明显增高(P<0.05);而联合用药组与氯沙坦治疗组比较,MDA和尿微量白蛋白水平下降(P<0.05)、SOD活性增高(P<0.05)更显著。结论 糖脉康联合氯沙坦能有效降低早期糖尿病肾病患者的OS和微量白蛋白尿水平,从而保护其肾脏功能。
【关键词】
糖脉康;氯沙坦;早期糖尿病肾病;氧化应激;微量白蛋白尿
Effect Of Tangmaikang Combined With Losartan On Oxidative Stress And Microalbuminuria In Patients With Early Diabetic Nephropathy
ZHU Qun, SHAO Xue-jing, NIE Ling-ling,et al.
Department of Endocrinology, Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China
【Abstract】 To investigate the effect of tangmaikang combined with losartan on oxidative stress(OS)and microalbuminuria in patients with early diabetic nephropathy. Methods 67 type 2 diabetic patients with early diabetic nephropathy were randomly divided into losartan (n=34)and combined group(n=33). Maleicdialdehyde(MDA, the marker of OS), superoxide dismutase(SOD)and microalbuminuria from these two groups (pre-and post-treatment)were determined. Results After 3 months treatment，the levels of MDA and microalbuminuria in losartan group were significantly decreased (P<0.01), and the activity of SOD in those patients was significantly increased(P<0.05). The decreases of microalbuminuria and MDA in combined group were more obvious than in losartan group(P<0.05), while the increase of SOD activity in combined group was more obvious than in losartan group(P<0.05) Conclusion Combined tangmaikang with losartan has good effects in decreasing OS level and microalbuminuria and protecting the renal function in patients with early diabetic nephropathy.
【Key words】 Tangmaikang; Losartan; Early diabetic nephropathy; Oxidative stress; Microalbuminuria
糖尿病肾病是糖尿病常见的微血管并发症之一。糖尿病肾病的发病机制尚不完全清楚,近年的研究显示,氧化应激(oxidativestress,OS)可能在糖尿病肾病发生和进展中扮演着关键的角色[1]。研究证实,血管紧张素Ⅱ受体拮抗剂能有效防治糖尿病肾病的进展,而减轻糖尿病肾病OS是其主要作用机制之一[2]。本研究将进一步观察中药制剂糖脉康联用血管紧张素Ⅱ受体拮抗剂氯沙坦对早期糖尿病肾病患者尿微量白蛋白及OS水平的影响。
1 资料与方法
1.1 一般资料
选取2008年10月至2009年10月在我院内分泌科住院及门诊2型糖尿病患者67例,其中男32例,女35例,年龄42～71(59.2±6.3)岁。全部患者均符合以下标准:(1)WHOl999年制定的2型糖尿病诊断标准;(2)均符合早期糖尿病肾脏病变的诊断:24h尿微量蛋白定量30～300mg为早期糖尿病肾病[3];(3)排除标准:糖尿病急性并发症,感染,冠心病,脑血管病变,恶性肿瘤,血液病,甲减,脏器功能不全等可能影响机体OS、糖脂代谢的因素 ......
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