阿魏酸钠治疗临床糖尿病肾病的初步研究

Preliminary Study on Effects of Sodium Ferulate in Treating Diabetic Nephropathy

目的探讨阿魏酸钠对临床糖尿病肾病的治疗作用和机制。方法80例2型糖尿病合并临床糖尿病肾病患者随机分为常规治疗组和阿魏酸钠组各40例,另选40名健康人作健康对照组。常规治疗组给予糖尿病饮食、皮下注射胰岛素治疗,阿魏酸钠组在此基础上加用阿魏酸钠300mg/d静脉滴注,治疗期时间4周。测定治疗前后空腹血糖(FBG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、血清肌酐(SCr)、尿素氮(BUN)、血清Ⅳ型胶原(CⅣ)、平均动脉压(MAP)、24h尿白蛋白排泄率(UAER)、血浆内皮素(ET)水平。结果治疗后阿魏酸钠组和常规治疗组FBG和HbAlc均较治疗前显著下降,但组间比较差异无显著性(P>0·05)。糖尿病肾病患者治疗前TG、TC、MAP、SCr、BUN、UAER、CⅣ、ET均较健康对照组明显升高(P<0·05)。常规治疗组治疗前后差异无显著性(P>0·05),阿魏酸钠组上述各项指标均显著降低(P<0·05),两组间差异有显著性(P<0·05)。结论阿魏酸钠可能有益于改善临床糖尿病肾病脂质代谢紊乱,降低血压、UAER和CⅣ,改善肾功能。阿魏酸钠的作用机制可能与其减少ET的生成或拮抗ET与其受体结合有关。

Objective To investigate the effects and mechanisms of sodium ferulate （SF） in treating diabetic nephropathy （DN）, Methods Eighty patients of diabetes mellitus type 2 with DN were randomly divided into two groups, 40 cases in each group, The routine group treated with conventional treatment including dietary therapy and hypodermic injection of insulin, and the SF group treated with intravenous dripping of SF 300 mg/d additionally besides the conventional therapy, the therapeutic course for both groups was 4 weeks. And 40 healthy volunteers were allocated in a group for normal control, Before and after therapy, levels of fasting blood glucose （FBG）, hemoglobin A1e （ HbA1c）, triglyceride （TG）, total cholesterol （TC）, high-density lipoprotein （HDL-C）, serum creatinine （SCr）, blood urea nitrogen （BUN）, mean arterial pressure （MAP）, urinary albumin excretion rate （UAER）, serum collagen type IV （CIV） and endothelin （ET） were detected. Results After 4 weeks of treatment, FBG and HbA1c reduced obviously in both groups with insignificant difference in comparison of them （P〉0.05）, Before treatment, TG, TC, MAP, SCr, BUN, UAER, CIV and ET were markedly higher in DN patients than those in the health control （P 〈 0.05）, these criteria decreased significantly in the SF group （P〈 0.05） but insignificantly in the routine group （P 〉 0.05） after treatment, showing difference between the two groups （P 〈 0.05）. Conclusion Sodium ferulate could ameliorate lipid metabolic disorder, reduce blood pressure, lower UAER and C IV level, and improve renal function in DN patients, the mechanism might be through decreasing ET production and inhibiting the combining of ET with its receptor.