【摘要】 目的 探讨法舒地尔对早期糖尿病肾脏疾病(diabetic kidney disease,DKD)患者尿结缔组织生长因子(connective tissue growth factor,CTGF)、单核细胞趋化因子1(monocyte chemoattractant protein-1,MCP-1)的影响。方法 采用随机数字表法将82例早期DKD患者分为阳性对照组(贝那普利片10 mg/次,1次/d)和法舒地尔治疗组(贝那普利加法舒地尔注射液60 mg,30 mg/次,2次/d),每组41例。所有患者严格控制血糖血压。分别于治疗前和治疗后第14天采用酶联免疫吸附法测定尿CTGF、尿MCP-1,采用免疫比浊法测定尿微量白蛋白(micro-albumin,mA1b),观察2组治疗前和治疗后第14天尿mA1b、CTGF、MCP-1变化,并采用Spearman相关分析分析尿mAlb、CTTGF、MCP-1的相关关系。结果 治疗前和治疗后两组间血糖、血压水平差异无统计学意义(P>0.05)。治疗后阳性对照组和法舒地尔治疗组尿mA1b、CTGF、MCP-1含量均较治疗前下降,差异有统计学意义(P<0.05);2组治疗前尿mA1b、CTGF、MCP-1含量比较,差异无统计学意义(P>0.05);2组治疗后尿mA1b、CTGF、MCP-1含量比较,差异有统计学意义(P<0.01)。相关分析显示mA1b含量与CTGF、MCP-1含量呈明显的正相关(P<0.05)。结论 法舒地尔有独立于肾素-血管紧张素系统(Renin-Angiotensin-System,RAS)阻断的肾脏保护作用,其降低早期DKD患者尿蛋白水平的机制可能与降低肾组织CTGF、MCP-1的水平有关。更多还原

【Abstract】 Objective To investigate the influence of fasudil on urine connective tissue growth factor(CTGF) and monocyte chemoattractant protein-1(MCP-1) in patients with early-stage diabetic? kidney? disease(DKD).Methods Eighty-two patients with early-stage DKD were randomly divided into the following two groups:positive control(benazepril tablets,10 mg each time,once a day)and fasudil-treated[benazepril tablets plus fasudil infusion(30 mg each time,twice a day)](n = 41each).All patients were under strict control of blood glucose and blood pressure.The contents of urine CTGF and MCP-1 were determined by enzyme linked immunosorbent assay,and the content of urine mAlb by immuno-turbidimetry respectively before and 14 days after treatment Changes in the contents of mAlb,CTGF and MCP-1 in the two groups were observed,and the relationship among mAlb,CTGF and MCP-1 was analyzed by using Spearman correlation analysis.Results There was no significant difference in serum glucose and blood pressure between two groups before and after treatment.Compared to before treatment,the contents of urine mAlb,CTGF and MCP-1 were significantly reduced after treatment in both positive control and fasudil-treated groups(P<0.05).There was no significant difference in the contents of urine mAlb,CTGF and MCP-1 between two groups before treatment(P>0.05).There was significant difference in the contents of urine mAlb,CTGF and MCP-1 between two groups after treatment(P<0.01).Correlation analysis revealed that mAlb was positively correlated with CTGF and MCP-1(P<0.05).Conclusions Kidney protection afforded by fasudil is independent of the renin-angiotensin system blockade.Fasudil may reduce the mAlb content in patients with early-stage DKD by probably inhibiting the expression of CTGF and MCP-1 in the kidney.更多还原