氯沙坦联合苯那普利对早期糖尿病肾病患者血清TGF-β_1及MCP-1的影响

Effect of combination therapy with Iosartan and captopril on monocyte chemoattractant protein-1 and transforming growth factor-β1 in patients with early diabetic nephropathy

目的观察氯沙坦联合苯那普利对早期糖尿病肾病(DN)血清转化生长因子-β1(TGF-β1)和单核细胞趋化蛋白-1(MCP-1)的影响。方法早期DN患者90例随机分为3组,A组给予氯沙坦100 mg.d-1,B组给予苯那普利10 mg.d-1,C组给予氯沙坦50 mg.d-1和苯那普利5 mg.d-1,疗程3个月,比较治疗前后血TGF-β1和MCP-1水平的变化。结果3组DN患者血清TGF-β1和MCP-1水平均明显低于治疗前水平(P<0.05),而且C组TGF-β1和MCP-1水平在治疗后明显低于A组和B组(P<0.01)。结论氯沙坦和苯那普利联用比单用具有更显著的降低DN患者血清TGF-β1和MCP-1水平的作用。

Objective To investigate the effect of combination therapy with Iosartan and captopril on monocyte chemoattractant protein-1 （ MCP-1 ） and transforming growth factor-β1 （ TGF-β1 ） in patients with early diabetic nephropathy （DN）. Methods Ninety early DN patients were randomly divided into three groups： A group received Iosartan （ 100 mg·d ^-1 ）, B group received captopril （ 10 mg·d ^-1 ） and group C received combination therapy of Iosartan （50 mg·d ^-1 ） and captopril （5 mg·d ^-1） for 3 months. After the 3 months, the serum levels of MCP-1 and TGF- β1 before and after medication in patients were oberved. Results After the three months medication, the serum levels of MCP-1 and TGF-β1 decreased significantly in three groups（P〈0.05）. In addition, the serum levels of MCP-1 and TGF-β1 decreased significantly in group C than that in group A and group B （P〈 0.01 ）. Conclusion Losartan combined with captopril may decrease the serum levels of MCP-1 and TGF-β1 at a greater extent than that use of iso sartan and captopril alone for DN patients.