氯沙坦对糖尿病肾病患者氧化应激的影响

Effect of Losartan on Oxidative Stress in Patients with Diabetic Nephropathy

目的:探讨氯沙坦对糖尿病肾病(DN)氧化应激的影响。方法:DN 64例,常规降糖并服氯沙坦100mg/d,健康自愿者20例为对照。测定血糖、血脂、氧化低密度脂蛋白(ox-LDL)、晚期氧化蛋白产物(AOPPs);血及尿超氧化物歧化酶(SOD)、丙二醛(MDA)、尿单核细胞趋化蛋白1(MCP-1)及白蛋白排泄率(UAER)。结果:与对照组比较,DN患者SOD活性降低,血清MDA、ox-LDL和AOPPs升高,尿MCP-1降低。氯沙坦治疗后,SOD活性升高,MDA、ox-LDL和AOPP降低,尿MCP-1升高,MDA和UAER降低。血清MDA、ox-LDL、AOPPs、尿MCP-1与UAER呈正相关(P<0.05),SOD与UAER呈负相关(P<0.05)。结论:氯沙坦可抑制DN患者氧化应激,从而减少尿蛋白排泄。

Objective：To investigate the effect of losartan on oxidative stress in patients with diabetic nephropathy（DN）.Methods：Sixty four patients with DN were enrolled to be treated with losartan（orally,100 mg/d）in addition to the routine treatment regulating blood glucose,and 20 healthy person were selected as control.The level of blood glucose（BG）,triglyceride（TG）,total cholesterol（TCH）,low density lipoprotein（LDL） and 24 h urinary albumin excretion rate（UAER） were measured.The concentration of serum or urine ox-LDL and MCP-1 were determined with ELISA.The concentration of serum advanced oxidation protein products（AOPP）and urine malonaldehyde（MDA） and the activity of serum or urine Superoxide Dismutase（SOD） were detected With spectrophotography.Results：Comparison with control,the levels of serum MDA、ox-LDL and AOPPs were significantly increased,the activity of serum SOD was decreased markedly,the concentrations of urine MDA and MCP-1 were higher and the urine SOD activity was lower in patients with DN.These changes could be reversed by treatment with losantan for 3 month.The UAER was positively correlated with serum MDA,ox-LDL,AOPP and MCP-1（r= 0.88,0.76,0.78,0.81 respectively,P〈0.05）,but UMER was negatively correlated with serum activity of SOD（r=-0.79,P〈0.05）.Conclusion：The results indicats that losartan plays a role in reducing urinary protein excretion through the mechanism of antioxidation and anti-inflammation within kidney.