肾康注射液对肾功能中度异常的糖尿病肾病患者炎性因子的影响

Influence of Shenkang Injection on Proinflammatory Cytokines in Patients with Diabetic Nephropathy and Moderate Renal Dysfunction

目的:探讨肾康注射液对肾功能中度异常的2型糖尿病肾病(DN)患者炎性因子的影响。方法:估计肾小球滤过率(eGFR)60~30 mL/(min·1.73 m2)DN患者24例,随机分成治疗组和对照组,对照组行常规治疗,治疗组在常规治疗基础上加用肾康注射液静脉滴注,干预观察持续8周,分别测定干预前后eGFR、高敏C-反应蛋白(hs-CRP)、白介素-6(IL-6)、血清肿瘤坏死因子α(STNF-α)、24 h尿蛋白定量(24hUPro)和尿肿瘤坏死因子α(UTNF-α)。结果:干预后治疗组eGFR显著升高,24hUPro、hs-CRP、STNF-α和UTNF-α显著降低,与对照组比较,差异有统计学意义(P均<0.05),IL-6虽降低并显著低于对照组(P=0.003),但自身前后比较无显著性差异(P=0.087)。对照组全部指标治疗前后无显著性差异(P均>0.05)。双变量相关性分析提示eGFR分别与hs-CRP、IL-6显著负相关,但相关关系不密切(r=-0.315,-0.295;P=0.029、0.042),偏相关分析则提示相关不显著,但P均接近0.05;24hUPro仅与UTNF-α显著正相关(r=0.387;P=0.007)。讨论:肾功能中度异常的DN患者eGFR和24hUPro分别与体内和肾内炎症状态相关,肾康注射液可以降低炎性因子水平,减轻炎症状态,减少尿蛋白,并改善肾功能。

Objective To investigate the influence in Shenkang injection on proinflammatory cytokines of the patients with type 2 diabetic nephropathy(T2DN) and moderate renal dysfunction.Methods A total of 24 T2DN patients with estimated glomerular filtration rate(eGFR) 60 ~ 30 mL /(min·1.73 m2) were enrolled in this study.The patients were randomly divided into treatment group and control group.The patients in treatment group were given Shenkang injection and conventional therapy.The patients in control group were given conventional therapy.The study lasted for 8 weeks.The levels of eGFR,high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),serum tumor necrosis factor-α(STNF-α),24 h urine protein level(24 h Upro) and urine tumor necrosis factor-α(UTNF-α) were measured before and after the study.Results After treatment,the level of eGFR significantly increased in treatment group,but the levels of 24 h Upro,hs-CRP,STNF-α and UTNF-α significantly decreased and had significant difference compared with those in control group(all P < 0.05).The level of IL-6 in treatment group had no significant change before and after treatment(P >0.05),but obviously lower than that in control group(P < 0.01).All indexes in control group had no significant change(all P >0.05).Bivariate correlation analysis showed that eGFR had slightly negative correlation with hs-CRP and IL-6(r =-0.315,-0.295,both P < 0.05),but partial correlation analysis showed no correlation(all P >0.05).Bivariate correlation analysis showed that only UTNF-α had slightly positive correlation with 24 h UPro(r = 0.387,P = 0.007).Conclusion The levels of eGFR,24 h UPro may relate with the inflammatory state in patients with T2DN and moderate renal dysfunction.Shenkang injection could decrease the level of proinflammatory cytokines,alleviate inflammatory state,reduce urine protein and improve renal function.