【摘要】 目的观察α-硫辛酸治疗糖尿病肾病的疗效。方法 78例2型糖尿病肾病Ⅲ期患者,随机分为硫辛酸组43例和对照组35例,硫辛酸组予以α-硫辛酸注射液600mg静脉滴注,一日一次,半月后改为α-硫辛酸胶囊300mg,2次/d及氯沙坦100mg/d,对照组给予氯沙坦100mg/d,总疗程12周。治疗前后分别进行一般项目监测和24h尿微量白蛋白(24hAlb)、层黏连蛋白(LN)、IV型胶原(C-Ⅳ)、超敏C反应蛋白(hsCRP)的定量测定及尿中足细胞计数。结果治疗前2组患者的一般项目和监测指标相比均无统计学意义;硫辛酸组和对照组HbA1C、24hAlb、LN、C-Ⅳ、hsCRP、足细胞计数治疗后较治疗前均有显著下降,差异有统计学意义(均P<0.05),高密度脂蛋白胆固醇(HDL-C)治疗后较治疗前有显著上升,差异有统计学意义(均P<0.05);硫辛酸组治疗后较对照组治疗后24hAlb有明显下降(P<0.05);硫辛酸组HbA1C、24hAlb、C-Ⅳ、足细胞计数下降幅度较对照组有显著降低,差异有统计学意义(均P<0.05)。用药过程中2组患者均无严重不良反应发生。结论α-硫辛酸可以减少糖尿病肾病尿微量白蛋白及足细胞的凋亡,氧化应激在DN的发生发展中起重要的作用。更多还原

【Abstract】 Objective To investigate the efficacies of thioctie acid on diabetic nephropathy(DN).Methods 78 patients of type 2 diabetes with stageⅢ DN were randomized into two groups:43 patients in thioctie acid group received losartan 100 mg/d,and α-thioctic acid 600 mg/d for 15 days,then α-thioctic acid capsule 300 mg/d;while the other 35 patients in control group,received losartan 100 mg/d;all for 12 weeks.The levels of 24h urine albumin,laminin(LN),IV-collagen(C-IV),high sensitive C-creative protein(hsCRP) and urinary podocytes were measured before and after treatments.Results There was no difference in general and monitoring items between thioctic acid group and control group at baseline(all P>0.05);After 12 weeks treatment,the levels of 24 h urine albumin,LN,C-IV,hsCRP,and urinary podocytes in two groups decreased significantly,and the level of HDL-C in two groups increased significantly than those in baseline(all P<0.05);After 12 weeks treatment,the levels of 24 h urine albumin,C-IV,and urinary podocytes were decreased in thioctic acid group than those in control group(all P<0.05).No serious adverse reaction occurred in both groups during the treatment.Conclusion Thioctic acid may decrease the amount of proteinuria in diabetic nephropathy;And in DN developing,oxidative stress may be play a great role in the process of the development of DN.更多还原