伊贝沙坦降低2型糖尿病肾病患者血清单核细胞趋化蛋白-1水平

Effect of irbestartan on serum monocyte chemoattractant protein-1 in patients with nephropathy due to type 2 diabetes

目的:探讨伊贝沙坦对2型糖尿病肾病患者血清糖基化终产物-肽(AGE-肽)和单核细胞趋化蛋白-1(MCP-1)水平的影响。方法:2型糖尿病伴微量白蛋白尿患者(尿白蛋白/肌酐30～300μg.mg-1)60例,随机分为实验组(口服瑞易宁加依贝沙坦)和对照组(仅口服瑞易宁),时间为6个月。流动注射分析法检测血清AGE-肽水平、ELISA法检测血清MCP-1水平。结果:实验组治疗后血清MCP-1水平较治疗前明显下降,且明显低于对照组;两组患者治疗后血清AGE-肽水平均较治疗前下降,实验组略低于对照组;实验组治疗后尿白蛋白/肌酐下降值与MCP-1下降值呈明显正相关。结论:伊贝沙坦通过降低2型糖尿病肾病患者血清MCP-1水平发挥肾保护效应。

Objective To investigate the effect of irbestartan on serum advanced glycosylation end products-peptide （AGE-P） and monocyte chemoatt ractant protein-1 （MCP-1） in patients with nephropathy due to type 2 diabetes（DN）. Methods 60 patients with type 2 diabetes with microalbuminuria （ UMA 30-300 μg·mg^-1 ） were conducted into two groups randomly. 30 were treated with irbestartan plus glipizide and the others were treated with glipizide alone for six months. Serum AGE-P and MCP-1 were measured by flow injection assay and ELISA respectively before and after treatment. Results Serum MCP-1 in patients with irbestartan plus glipizide decreased significantly after treatment, showing significant difference as compared with that in patients with glipizide alone. Serum AGE-P in all patients was significantly decreased after treatment, but there was no significant difference between the two groups after treatment for three months. However, it was lower in patients with irbestartan plus glipizide after treatment for six months as compared with that in patients with glipizide alone. The reduction of proteinuria/creatinine correlated highly significant with the change in set- abetes and suggests that irbestartan might play the role of reno-protection through suppression of the serum MCP-1.