罗格列酮对糖尿病肾病患者内皮功能的影响

Effects of Rosiglitazone on Vascular Endothelial Function in Patients with Early Diabetic Nephropathy

目的观察罗格列酮对早期糖尿病肾病(DN)患者炎症因子和内皮功能的影响。方法将50例糖尿病肾病Ⅲ期患者随机分为两组,所有患者均采用胰岛素控制治疗,A组患者给予安慰剂,B组患者口服罗格列酮8mg。治疗前及治疗16周后检测血糖、糖化血红蛋白、血清超敏C反应蛋白(hs-CRP)、IL-6、TNF-α、基础肱动脉内径、内皮依赖性血流介导的舒张反应(FMD),以20例正常成人为对照。结果治疗前糖尿病肾病两组患者血清hs-CRP、IL-6和TNF-α水平明显高于正常对照组,其肱动脉内径(F0)和FMD明显低于对照组。治疗后,罗格列酮组的hs-CRP、IL-6和TNF-α水平明显降低,肱动脉内皮依赖性舒张功能明显增加,而安慰剂组无显著改变。结论早期糖尿病肾病患者存在炎症状态和血管内皮功能障碍,罗格列酮可减轻糖尿病肾病患者炎症状态,改善血管内皮功能,对早期糖尿病肾病患者有重要保护作用。

Objective To investigate the effects of rosiglitazone on the inflammatory factors and vascular endothelial function in patients with early diabetic nephropathy （DN）. Methods 50 patients with microalbuminuria were randomly divided into two groups：Group A was treated with insulin and placebo, while group B with insulin and 8rag rosiglitazone. 20 health persons were as the control group. Before and after the treatment of 16 weeks ,FPG, HbAlc, serum CRP, IL-6 and TNF-α in three groups were detected, and high-resolution ultrasound examination was performed to measure the baseline diameter and the endothelium-de- pendent flow mediate dilation （FMD） of brachial artery. Results Before the treatment, significant increase in serum CRP, IL-6 and TNF-α were observed in group A and B as compared with the control group; but the baseline diameter of brachial artery and the FMD of brachial artery were impaired in group A and B. After the treatment of 16 weeks, the serum CRP, IL-6 and TNF-α were much lower in rosiglitazone group than that in placebo group; FMD increased obviously in rosiglitazone group but not in placebo group. Conclusion Inflammatory factors and endothelial function degression present in patients with early diabetic ne- phropathy. Rosiglitazone can reduce the level of CRP, IL-6 and TNF-α, improve the endothelial function.