黄芪注射液对2型糖尿病肾病患者血中Ⅳ型胶原与转化生长因子-β1水平变化及意义

The effect of astragalus injection on the serum levels of type IV collagen and in the patients of type -2 diabetic nephropathy

目的通过黄芪注射液治疗2型糖尿病肾病（T2-DN）患者血中Ⅳ型胶原（Coll Ⅳ与转化生长因子-β1（TGF-β1）水平变化，探讨黄芪注射液对T2-DN的治疗作用及机理。方法80例2型糖尿病（T2-DM）患者根据尿微量白蛋白（UAER）排泄率分为T2-DM无肾病组37例和T2-DN组43例，另设30例健康对照组。T2-DN组接受黄芪注射液治疗。分别检测其血糖、Coll Ⅳ、TGF-β1与尿UAER水平。结果治疗前T2-DM患者血中Coll Ⅳ、TGF-β1和UAER水平较对照组明显升高，T2-DN组较无肾病组也明显升高，且相关分析表明，血清CollIV、TGF-β1水平与尿UAER呈正相关，Coll Ⅳ与TGF-β1呈正相关。经黄芪治疗后，血中CollⅣ与TGF—β1水平显著降低，尿UAER含量也显著降低。结论T2-DM患者存在胶原代谢异常，且与TGF-β1过度表达有关，黄芪治疗T2-DN的机制可能是通过抑制TGF—β1的产生和Coll-Ⅳ的合成来实现的。

Objective To study the effect of astragalus injection on the serum levels of type Ⅳ collagen and transforming growth factor-β1 （TGF-β1） in the patients of type-2 diabetic nephropathy. Methods 80 patients with type 2 diabetes were divided into diabetic nonephropathy group （37patients）and type-2 diabetic nephropathy group（43patients）according to urine albumin excretion rate （UAER）. 30 healthy subjectives were as controis. Patients with type-2 diabetic nephropathy were treated by astragalus injection. Blood glucose, blood type Ⅳ collagen（Coil Ⅳ）, TGF β1 and UAER were detected in all cases. Results The levels of C Ⅳ, TGF-13 1 and UAER in the patients with type-2 diabetes were significantly increased cnmpaired with control. The levels of coil Ⅳ, TGF-131 and VAER were significantly higher in the patients with type 2 diabetic nephropathy than that in the type-2 diabetes patients with no-nephropathy. Correlation analysis showed that the levels of Coll Ⅳ and TGF-[31 were positively correlated with UAER. The level of Coil Ⅳ was positively correlated with that of TGF-β1. The level of C Ⅳ, TGF-β1 and UAER were significantly decreased after astragalus injection treatment. Conclusion The abnormal collagen metabolism in the patients with type-2 diabetic nephropathy is related to additional TGF-β1 . The mechanisms of Astragalus injeetion in treatment type-2 diabetic nephropathy might be related to the inhibition of the produetion of TGF-β1 and Ⅳ collagen.