噻唑烷二酮类药物肾脏保护作用研究进展

Effects of thiazolidinediones on protection of the kidney

噻唑烷二酮类（TZDs）药物为过氧化物酶体增殖物活化受体（PPAR）γ激动剂，是一类通过胰岛素增敏作用来治疗2型糖尿病的药物。研究表明，肾脏系膜细胞、肾小管细胞及足细胞上均存在PPARγ。越来越多的动物及临床证据支持TZDs药物可以通过改善肾脏血流动力学和内皮功能、抗糖基化、抑制炎性反应、氧化应激等多种机制来延缓肾脏衰竭，发挥直接的肾脏保护作用，且不依赖于改善糖、脂代谢，降低高胰岛素血症的全身作用。因此，为糖尿病肾病及其他慢性。肾病的药物治疗提供了新的思路和方法。

Thiazolidinediones （ TZDs ） --peroxisome proliferators activated receptor （ PPAR ）γ activa- tor,are a class of antidiabetie drugs for type 2 diabetes mellitus through their insulin sensitizing action. Studies have shown that PPARγ lies in intereapillary cell, tubular cell and podocyte, etc. More and more animal and clinic evidences support the concept that TZDs can delay renal failure and have a directly protective effect against kidney by several mechanisms,sueh as improving kidney haemodynamics and endothelium function, inhibiting glycosylation, anti-inflammation, reduction of oxidative stress, etc. In addition, these effects are independent of lowing hyperglyeaemia, hyperlipemia and hyperinsulinism. TZDs provide new concept and method in treating diabetic nephropathy and other chronic kidney diseases.