胰激肽原酶联合舒洛地特治疗糖尿病肾病的疗效及对氧化炎症状态、足细胞损伤的影响
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摘要
目的:探讨胰激肽原酶联合舒洛地特治疗糖尿病肾病(DN)的效果,分析患者氧化炎症状态、足细胞损伤程度的变化。方法:选取2016年8月-2018年8月在本院接受治疗的DN患者96例,按随机数字表法分为对照组(n=48,接受常规+胰激肽原酶治疗)、研究组(n=48,接受常规+胰激肽原酶+舒洛地特治疗)。对比两组近期疗效、血清氧化应激指标及炎症指标含量、尿液足细胞损伤指标(Podocin、Nephrin、Mindin)水平的差异。结果:治疗后,研究组治疗总有效率高于对照组(P<0.05);血清中高级氧化蛋白产物(AOPPs)、白介素-1(IL-1)、白介素-18(IL-18)含量均低于对照组(P<0.05),超氧化物歧化酶(SOD)含量高于对照组(P<0.05);尿液中Podocin、Nephrin、Mindin水平均低于对照组(P<0.05)。结论:胰激肽原酶联合舒洛地特用于DN治疗,有助于提升疗效并减轻机体氧化炎症及足细胞损伤。
Objective:To investigate the effect of Pancreatic Kallikrein combined with Sulodexide in the treatment of diabetic nephropathy(DN),and analyze the changes of oxidative inflammation and podocyte damage.Method:96 cases of DN patients from August 2016 to August 2018 were divided into control group(n=48,routine treatment + Pancreatic Kallikrein therapy),research group(n=48,routine treatment + Pancreatic Kallikrein + Sulodexide therapy)by random number table method.The short-term efficacy,serum contents of oxidative stress indicators and inflammatory indicators,indicators of urinary podocyte injury were compared between two groups.Result:After treatment,the total effective rate of the research group group was higher than that in control group(P<0.05),serum contents of advanced oxidative protein products(AOPPs),interleukin-1(IL-1),interleukin-18(IL-18)of the research group were lower than those in control group(P<0.05),content of superoxide dismutase(SOD)of the research group was higher than that in control group(P<0.05),levels of Podocin,Nephrin and Mindin in urine of the research group were lower than those in control group(P<0.05).Conclusion:Pancreatic Kallikrein combined with Sulodexide in the treatment of DN can improve the therapeutic effect and reduce oxidative inflammation and podocyte injury.
Objective:To investigate the effect of Pancreatic Kallikrein combined with Sulodexide in the treatment of diabetic nephropathy(DN),and analyze the changes of oxidative inflammation and podocyte damage.Method:96 cases of DN patients from August 2016 to August 2018 were divided into control group(n=48,routine treatment + Pancreatic Kallikrein therapy),research group(n=48,routine treatment + Pancreatic Kallikrein + Sulodexide therapy)by random number table method.The short-term efficacy,serum contents of oxidative stress indicators and inflammatory indicators,indicators of urinary podocyte injury were compared between two groups.Result:After treatment,the total effective rate of the research group group was higher than that in control group(P<0.05),serum contents of advanced oxidative protein products(AOPPs),interleukin-1(IL-1),interleukin-18(IL-18)of the research group were lower than those in control group(P<0.05),content of superoxide dismutase(SOD)of the research group was higher than that in control group(P<0.05),levels of Podocin,Nephrin and Mindin in urine of the research group were lower than those in control group(P<0.05).Conclusion:Pancreatic Kallikrein combined with Sulodexide in the treatment of DN can improve the therapeutic effect and reduce oxidative inflammation and podocyte injury.
引文
[1]鲁丽,单玲,王洋,等.3298例住院糖尿病患者临床特点与用药分析[J].中国现代药物应用,2017,11(21):187-188.
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[5]段欢欢.舒洛地特联合黄葵胶囊治疗IgA肾病的临床疗效观察[J].基础医学论坛,2016,20(26):3657-3658.
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[8]Yiu W H,Wong D W,Wu H J,et al.Kallistatin protects against diabetic nephropathy in db/db mice by suppressing AGE-RAGE-induced oxidative stress[J].Kidney Int,2016,89(2):386-398.
[9]桂福强,罗鸿,刘洪,等.舒洛地特对低氧状态下人真皮微血管内皮细胞凋亡的影响[J].中国病理生理杂志,2018,34(4):657-662.
[10]Zili?teanu D S,Atasie T,Voiculescu M.Efficacy of longterm low-dose sulodexide in diabetic and non-diabetic nephropathies[J].Rom J Intern Med,2015,53(2):161-169.
[11]徐贵华,袁利,陈永华,等.黄葵胶囊对糖尿病肾病氧化应激水平及内皮功能的影响[J].中国中西医结合肾病杂志,2018,19(2):137-139.
[12]聂东红.α-硫辛酸联合海昆肾喜胶囊对糖尿病肾病患者氧化应激及肾功能的影响[J].实用药物与临床,2018,21(3):296-298.
[13]Chen X,Fang M.Oxidative stress mediated mitochondrial damage plays roles in pathogenesis of diabetic nephropathy rat[J].Eur Rev Med Pharmacol Sci,2018,22(16):5248-5254.
[14]杨林燕,李英.抗氧化应激对糖尿病肾病肾脏损害的保护作用[J].中国中西医结合肾病杂志,2016,17(6):554-556.
[15]王力.糖尿病肾病患者微炎症状态与营养不良的相关性研究[J].内科急危重症杂志,2018,24(3):223-225.
[16]王鲁奎.糖尿病肾病发病机制探讨及最新治疗进展[J].基础医学论坛,2018,22(7):989-990.
[17]Moreno J A,Gomez-Guerrero C,Mas S,et al.Targeting inflammation in diabetic nephropathy:a tale of hope[J].Expert Opin Investig Drugs,2018,27(11):917-930.
[18]殷洪波,于攀,李杰.糖尿病肾病足细胞损伤机制研究进展[J].解放军医药杂志,2018,30(3):113-116.
[19]安梦丽,何平.足细胞损伤的机制与肾小球疾病的关系研究进展[J].中国临床研究,2018,31(10):1427-1431.
[20]刘思梦,刘艳.足细胞损伤在狼疮性肾炎发病机制中的作用[J].国际泌尿系统杂志,2016,36(4):623-627.
[2]Lu Q,Wang W W,Zhang M Z,et al.ROS induces epithelialmesenchymal transition via the TGF-β1/PI3K/Akt/mTORpathway in diabetic nephropathy[J].Exp Ther Med,2019,17(1):835-846.
[3]石智勇,靳立英,辛国辉,等.胰激肽原酶联合替米沙坦治疗早期糖尿病肾病[J].中国实用医药,2018,13(9):132-133.
[4]孙中.舒洛地特联合缬沙坦治疗原发性肾小球肾炎的疗效研究[J].中国社区医师,2018,34(1):64,66.
[5]段欢欢.舒洛地特联合黄葵胶囊治疗IgA肾病的临床疗效观察[J].基础医学论坛,2016,20(26):3657-3658.
[6]中华医学会糖尿病学分会微血管并发症学组.糖尿病肾病防治专家共识(2014年版)[J].中华糖尿病杂志,2014,6(11):792-801.
[7]Liu W,Yang Y,Liu Y,et al.Exogenous kallikrein protects against diabetic nephropathy[J].Kidney Int,2016,90(5):1023-1036.
[8]Yiu W H,Wong D W,Wu H J,et al.Kallistatin protects against diabetic nephropathy in db/db mice by suppressing AGE-RAGE-induced oxidative stress[J].Kidney Int,2016,89(2):386-398.
[9]桂福强,罗鸿,刘洪,等.舒洛地特对低氧状态下人真皮微血管内皮细胞凋亡的影响[J].中国病理生理杂志,2018,34(4):657-662.
[10]Zili?teanu D S,Atasie T,Voiculescu M.Efficacy of longterm low-dose sulodexide in diabetic and non-diabetic nephropathies[J].Rom J Intern Med,2015,53(2):161-169.
[11]徐贵华,袁利,陈永华,等.黄葵胶囊对糖尿病肾病氧化应激水平及内皮功能的影响[J].中国中西医结合肾病杂志,2018,19(2):137-139.
[12]聂东红.α-硫辛酸联合海昆肾喜胶囊对糖尿病肾病患者氧化应激及肾功能的影响[J].实用药物与临床,2018,21(3):296-298.
[13]Chen X,Fang M.Oxidative stress mediated mitochondrial damage plays roles in pathogenesis of diabetic nephropathy rat[J].Eur Rev Med Pharmacol Sci,2018,22(16):5248-5254.
[14]杨林燕,李英.抗氧化应激对糖尿病肾病肾脏损害的保护作用[J].中国中西医结合肾病杂志,2016,17(6):554-556.
[15]王力.糖尿病肾病患者微炎症状态与营养不良的相关性研究[J].内科急危重症杂志,2018,24(3):223-225.
[16]王鲁奎.糖尿病肾病发病机制探讨及最新治疗进展[J].基础医学论坛,2018,22(7):989-990.
[17]Moreno J A,Gomez-Guerrero C,Mas S,et al.Targeting inflammation in diabetic nephropathy:a tale of hope[J].Expert Opin Investig Drugs,2018,27(11):917-930.
[18]殷洪波,于攀,李杰.糖尿病肾病足细胞损伤机制研究进展[J].解放军医药杂志,2018,30(3):113-116.
[19]安梦丽,何平.足细胞损伤的机制与肾小球疾病的关系研究进展[J].中国临床研究,2018,31(10):1427-1431.
[20]刘思梦,刘艳.足细胞损伤在狼疮性肾炎发病机制中的作用[J].国际泌尿系统杂志,2016,36(4):623-627.