川芎嗪联合苯那普利对糖耐量受损者肾微血管病变的保护作用

Protective effects of tetramethylpyrazine combined with benazepril on pathological changes of renal micrangium in patients with impaired glucose tolerance

目的观察川芎嗪注射液联合苯那普利对糖调节受损(IGT)患者24 h尿微量白蛋白(mALB)、胱抑酸C(CysC)、C-反应蛋白(CRP)及白介素-18(IL-18)的影响。方法根据患者口服葡萄糖耐量试验(OGTT)结果,将74例IGT患者随机分为A、B两组,A组为对照组,予以常规治疗;B组为治疗组,除常规治疗外,加用苯那普利10 mg口服,1次/d;川芎嗪注射液40 ml静脉滴注,1次/d。14 d为1疗程,共用2个疗程。分别检测患者治疗前后尿mALB及血清CysC、CRP及IL-18的变化。结果治疗组治疗后,患者尿mALB及血清CysC明显降低,CRP与IL-18水平明显下降,与治疗前及对照组比较均有显著性差异(P<0.05)。结论川芎嗪注射液联合苯那普利能有效减少IGT患者尿蛋白排泄,降低血清CysC、CRP及IL-18水平,表明此两药联合对IGT肾微血管病变具有显著防护作用,其机制可能与抑制肾脏内炎症反应有关。

Objective To observe the effects of tetramethylpyrazine （TMP）combined with benazepril on the 24 - hour urinal microalbumin（mALB） ,CysC,C - reactive protein（CRP） and interleukin - 18 （IL - 18 ）in patients with impaired glucose tolerance （IGT）. Methods According to the oral glucose tolerance test（OGTI＇） results of 74 patients with IGT, they were randomly divided into group A and B. Group A was control group receiving conventional treatment. Group B was treatment group receiving the conventional treatment plus oral administration of 10 mg benazepril once a day and intravenous drip with 40 ml TMP injection once a day. Fourteen days was a course of treatment, and both groups were treated for two courses. The urinal mALB, serum CysC, CRP and IL - 18 of bothgroups were detected before and after the treatment. Results After the treatment, the urinal mALB, serum CysC and the levels of CRP and IL - 18 in the treatment group decreased significantly. In the treatment group,there were significant differences between the above indexes before and after the treatment, and those indexes were also lower than those in the control group after the treatment（ P 〈 0.05 ）. Conclusion TMP injection combined with benazepril can reduce urinal protein excretion in patients with IGT, decrease the levels of CysC, CRP and IL - 18, which indicates that this combination has obvious protective effects on pathological changes of renal micrangium and its mechanism may have correlation with the inhibition of inflammatory reaction within the kidney.