糖尿病肾病治疗前后血管紧张素-Ⅱ、血管内皮生长因子、内皮素和心钠素含量变化

Blood Angiotensin-Ⅱ(AT-Ⅱ),Vascular Endothelial Growth Factor(VEGF),Endothelin(ET) and Atrial Natriuretic Peptide(ANP) Levels Before and fter Treatment in Patients With Diabetic Nephropathy

目的检测糖尿病肾病(DN)患者治疗前后血管紧张素-Ⅱ(AT-Ⅱ)、血管内皮生长因子(VEGF)、内皮素(ET)和心钠素(ANP)含量变化,以比较不同药物的治疗效果。方法DN患者80例分为:中药治疗观察组40例;对照组40例;正常对照组35例。用放免法和ELISA法分别测定治疗前后血浆AT-Ⅱ、VEGF、ET和ANP水平。结果两组DN患者治疗前AT-Ⅱ、VEGF、ET和ANP含量均明显高于正常对照组(P<0.05～0.01),治疗后较治疗前明显降低(P<0.05～0.01)。观察组治疗后各因子含量下降较对照组明显。糖尿病肾病患者AT-Ⅱ含量与VEGF呈正相关(r=0.565,P<0.05),血浆ET含量与ANP呈正相关(r=0.674,P<0.05),观察组疗效稍好于对照组。结论AT-Ⅱ、VEGF、ET和ANP与DN的发生发展和病情的严重程度有关,中西药结合治疗糖尿病肾病患者效果较好。

Objective To evaluate the treatment effect of Chinese herb medicine by observing variations of blood AT- Ⅲ ,VEGF,ET and ANP levels in patients with diabetic nepbropathy（DN）.Methods 80 cases were divided in to two groups： combined Chinese herb with western medicine treated group（ n = 40） and western medicine only group（ n = 40）. Blood was tested for levels of AT- Ⅱ ,ET,ANP（with RIA） and VEGF（WIth ELISA）in all the patients both before and 12 weeks after starting the treatment as well as in 35 controls. Results AT- Ⅱ,VEGF,ET and ANP levels were significantly higher in patients of the two DN groups than those in the controls（ P 〈 0.05 - 0.01） and decreased significandy after treatment in both groups（ P 〈 0.05 - 0.01）. In the two DN groups,AT- Ⅱ level was positively correlated to VEGF level （ r =0.565, P 〈0.05） and ET was positively correlated to ANP （ r =0.674, P 〈0.05）.Result of treatment was slightly better in the herb combined group. Conclusion Blood AT - Ⅱ , VEGF, ET and ANP were substances that played important role in the pathogenesis of DN;measurement of which were ideal for evalultion of treatment effect. Result of treatment was more desirable with additional herb medicine.