雷公藤多甙对糖尿病肾病病人尿足细胞排泄的影响

THE INFLUENCE OF TRIPETERYGIUM WILFORDII ON URINE PODOCYTE EXCRETION IN PATIENTS WITH DIABETIC NEPHROPATHY

目的探讨雷公藤多甙对糖尿病肾病(DKD)病人尿足细胞排泄的影响。方法选取我院内分泌科和肾内科2009年10月—2010年2月住院及门诊DKD病人30例,其血肌酐正常,24 h尿蛋白>300 mg。将上述病人随机分为3组,对照组给予积极控制血糖、血压、血脂等对症支持治疗,在此基础上,治疗组给予雷公藤多甙1 mg/(kg.d),阳性对照组给予安博维300 mg/d,疗程均为8周。采用间接免疫荧光法检测3组病人治疗前后尿沉渣中足细胞数量。结果治疗后3组尿沉渣足细胞数均较治疗前显著减少(t=9.00～14.70,P<0.01)。阳性对照组、治疗组治疗后尿沉渣足细胞数显著少于对照组(F=3.92,q=2.20、2.50,P<0.01),而阳性对照组与治疗组比较差异无显著性(P>0.05)。结论雷公藤多甙可明显减少尿中足细胞的排泄,从而减少肾脏足细胞的损伤,达到肾脏保护作用。

Objective To explore the influence of tripterygium wilfordii（TW） on urine podocyte excretion in patients with diabetic nephropathy（DN）. Methods Thirty DN patients were enrolled in this study,who were hospitalized or outpatients of department of endocrinology or nephrology of the Affiliated Hospital during 10.2009—02.2010.All the patients had a normal level of serum creatinine,and their 24-hour urinary microalbuminuria was higher than 300 mg.The patients were randomly divided into three groups as treatment group,positive control group and control group.All the patients received supportive treatment to control the blood glucose,blood pressure and blood fat.Patients in the treatment group received additionally 1 mg/（kg·d） of TW,and those in the positive control group received Irbesartan tablets at the dose of 300 mg/d,the course of treatment was eight weeks for both groups.Podocytes in urine sediments were detected by indirect immunofluorescence before and after the treatment.Results The number of podocytes in all patients decreased after treatment（t=9.00-14.70,P0.01）.The number of podocytes in the treatment group and positive control group was fewer than that in the control group after treatment（F=3.92;q=2.20,2.50;P0.01）,and that of the difference between the positive control group and treatment group was not significant（P0.05）.Conclusion Tripterygium wilfordii can significantly reduce the excretion of urine podocytes,thus reduce the injury of podocytes,and protect the kidneys.