2型糖尿病肾病患者厄贝沙坦联合阿托伐他汀治疗后血尿转化生长因子β_1水平的变化

Changes of Level of Urine Transforming Growth Factor β_1 after Treatment of Diabetic Nephropathy with Irbesartan Combined with Atorvastatin

目的:对糖尿病早期肾病患者进行降糖及厄贝沙坦和阿托伐他汀治疗,检测血和尿转化生长因子β1(TTGF-β1)水平,比较厄贝沙坦、阿托伐他汀以及两药联合治疗对早期DN患者TTGF-β2的影响。方法:选取糖尿病早期肾病患者65例,随机分为厄贝沙坦组、阿托伐他汀组、厄贝沙坦联合阿托伐他汀治疗组,选取29名健康体检者作为正常对照。12周后采用放射免疫法检测24h尿白蛋白排泄率(UAER),双抗体夹心酶联免疫吸附试验(ELISA法)检测血清和尿液TTGF-β1水平。结果:早期DN患者血和尿TTGF-β1水平显著高于健康志愿者(P<0.01)。与治疗前基础值相比,两药均能减少UAER以及血和尿中TTGF-β1(P<0.05),以联合治疗更为明显。结论:早期DN患者血和尿TTGF-β1水平升高,厄贝沙坦、阿托伐他汀以及厄贝沙坦联合阿托伐他汀能有效降低TTGF-β1,血和尿TTGF-β1水平可以作为DN早期诊断和治疗效果评估的有效指标。

Objective： To determine changes of TTGF - β1 and treatment effects of Irbesartan, Atorvastatin and two - drug combining therapy in DN patients. Methods： Eighty - seven diabetic patients with micro - albuminuria, who were collected from Oct. 2010 to Jun. 2011 in our hospital, were randomLy assigned to the Irbesartan group （n = 23 ）, Atorvastatin group （n = 22） and two -drug combined group （n = 20）, and to receive Irbesartan, Atorvas- tatin and two - drug combining therapy respectively, or β1 healthy individuals served as the control group. 24 hour urinary albumin excretion rate （UAER） was. measured by radio -active immunoassay before and after 12 weeks treatment, as well serum/urine levels of TGF-β1 by double antibody sandwich ELISA. Results：As compared with healthy controls, early DN patients showed significantly higher serum and urine levels of TGF-β1 （P 〈 0.01 ）, and there was a positive correlated between TGT -β1and UAER （P 〈 0.01 ）. UAER and TTGF -β1 level decreased after treatment in the three group, especially in combined group, compared with before treatment （ P 〈 0.05 ）. Conclusions： Therapy of Irbesartan, Atorvastatin and two - drug combination can significantly reduce serum and u- rine level of TGF -β1 in patients with early DN. Level of TGF -β1 could be used as a specific indicator for early diagnosis and treatment evaluation in DN.