葡多酚对早期糖尿病肾病患者血浆内皮素的影响和意义

Effect and Clinical Significance of Grape Procyanidins on Endothelin-1 in Patients with early Stage diabetic nephropathy

目的:探讨葡多酚(GPC)对早期糖尿病肾病患者血浆内皮素-1(ET-1)和24小时尿白蛋白排泄率(UAER)等的影响及临床意义。方法:将38名早期糖尿病肾病患者随机分为实验组(n=19)和对照组(n=19)。对照组采用糖尿病常规治疗,实验组在常规治疗基础上加用葡多酚治疗,每天一次200mg口服,两组疗程均为8周。另选择20名正常人为健康组。采用放射免疫法分别测定对照组和实验组治疗前后血浆ET-1和24h尿白蛋白排泄率(UAER),测定健康组查体时的血浆ET-1。结果:早期糖尿病肾病实验组和对照组治疗前血浆ET-1均较健康人组血浆ET-1显著升高(p<0.01),早期糖尿病肾病患者治疗前血浆丙二醛水平与UAER呈显著正相关。早期糖尿病肾病实验组治疗8周后血浆ET-1(68±4.24ng/L)较治疗前血浆ET-1(115.8±15.5ng/L)显著下降(p<0.01),对照组治疗后血浆ET-1(106±10.7ng/L)较治疗前血浆ET-1(114±0.9ng/L)下降不明显(p>0.05),实验组治疗后UAER(70.51±32.17ug/min)较治疗前UAER(112.42±69.11ug/min)明显下降(p<0.01),对照组治疗后UAER(98.30±45.84ug/min)较治疗前UAER(103.15±69.14ug/min)下降不明显(p>0.05)实验组血浆ET-1降低与UAER降低呈显著正相关(p<0.01)。结论:糖尿病肾病(DN)的发生与血浆内皮素-1水平升高有关,提示了血管内皮损伤参与DN的发生发展。葡多酚明显降低糖尿病肾病(DN)血浆中内皮素-1含量,具有维持血管内皮细胞功能,对DN的肾脏功能起到一定改善和保护作用,为GPC治疗DN提供了理论依据。

Objective：To study the Effect and Clinical Significance of Grape Procyanidins on Endothelin -1 and UAER in Patients with early Stage diabetic nephropathy. Methods ： Random divison of 38 cases of early diabetic nephropathy into the contrasting group and the expcrmental group. The contrasting group was applied diatctie nephropathy（DN） regular treatment and the experpenta/group was added to Grape Procyanidins capsule on the basis of regular treatment one time pcrday and being taken 0.2g every time. Both of them would be treated 8 weeks. There was another group made of 20 healthy people, obtaining the changes of UAER andET - 1, and different group through radioimmunoussay method. Results：The level of plasma ET - Itaken from the DN patient, was higher than the health. Tbe level of plasma ET - 1, taken from the expermental group was obviously declined after having been treated （ P 〈0.01 ）. The level of plasma ET - 1 taken from the coatrasting group had no distinel change after having been treated （ P 〉 0.05 ）. The level of plasma ET - 1 and UAER taken from the expermental group ,was obviously declined compare with the contrasting group after taking treat of 8 weeks （ P 〈 0.01, P 〈 0.01 ）. The decline of plasma ET - 1 was obviously parallel to decline of UAER. Conclusion：The happening and development of DN maybe relate to the change about the level of plasma ET - 1. It suggest that endothelial injury may be involved in the pathogenesis of DN. Grape Procyanidins could reduce the DN patients plasma ET - 1 and protect the function of kidney. It provided the theoretical basis to treat DN by using Grape Procyandins.