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葡糖醛酸基葡糖胺聚糖硫酸盐对糖尿病肾病的干预效果

Effect of glucuronic acid glucosaminoglycan sulfate in intervening diabetic nephropathy

    摘要
  • 摘要:
      目的  观察葡糖醛酸基葡糖胺聚糖硫酸盐(舒洛地特)对糖尿病肾病(DN)患者的干预效果。
      方法  选择早期DN患者40例作为研究对象，将患者随机分为观察组与对照组，每组20例。对照组给予糖尿病常规治疗，观察组在此基础上给予舒洛地特肌肉注射治疗, 600 LSU/次, 1次/d, 5 d/周, 3周为1个疗程，停药1周后开始第2个疗程，共2个疗程。比较2组患者治疗前与治疗1、2、3个月后的尿丙二醛、尿白蛋白/肌酐(UACR)、尿转化生长因子-β1(TGF-β1)、血清脂联素(ADPN)、糖化血红蛋白(HbA1c)、估算肾小球滤过率(eGFR)、空腹血糖(FBG)的变化。
      结果  治疗前后, 2组间FBG、HbA1c水平比较，差异无统计学意义(P>0.05); 治疗后，观察组eGFR、血清ADPN水平高于对照组，尿丙二醛、UACR、尿TGF-β1水平低于对照组，差异有统计学意义(P < 0.05或P < 0.01)。
      结论  舒洛地特对DN患者肾血管功能及肾小管功能均有保护作用，且可能在早期即可延缓肾脏损害进展。

     

    Abstract:
      Objective  To observe effect of glucuronic acid glucosaminoglycan sulfate(sulodexide) in intervening diabetic nephropathy(DN).
      Methods  A total of 40 DN patients were enrolled and randomly divided into observation group(n=20) and control group(n=20). The control group was given routine treatment of diabetes. The observation group was given intramuscular injection of suloxide on this basis of the control group, the patients were treated by 600 LSU per time, once a day, 5 days a week, and 3 weeks as a course of treatment. The second course of treatment was started after 1 week of withdrawal, and the treatment lasted for two weeks. The changes of urinary malondialdehyde, urinary albumin to creatinine (UACR) ratio, urinary transforming growth factor-β1 (TGF-β1), serum adiponectin (ADPN), glycated hemoglobin (HbA1c), estimated glomerular filtration rate (eGFR) and fasting blood glucose (FBG) in two groups were compared before treatment and 1 month, 2 and 3 months after treatment.
      Results  There were no significant between-group differences in HbA1c and FBG between two groups before and after treatment(P>0.05). After treatment, the levels of eGFR and serum ADPN in the observation group were significantly higher than those in the control group, while the levels of urinary malondialdehyde, UACR and urinary TGF-β1 were significantly lower than those in the control group(P < 0.05 or P < 0.01).
      Conclusion  Sulodexide has protective effects on renal vascular function and renal tubular function in DN patients, and may delay the progression of renal damage in early stage.

     

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