螺内酯对糖尿病肾病患者尿8-异前列腺素F2α的影响

Effect of spirolactone on urinary 8-iso-prostaglandin F2α of diabetic nephropathy patients

目的了解螺内酯对糖尿病肾病患者尿8-异前列腺素F2α（8-iso-PGF2α）的影响。方法将78例糖尿病肾病患者按随机数字表法分为试验组（40例）和对照组（38例），对照组采用常规治疗，试验组在常规治疗的基础上加用螺内酯20mg／d，均治疗3个月。分别观察治疗前后收缩压、舒张压、空腹血糖、餐后2h血糖、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、糖化血红蛋白、尿白蛋白，尿肌酐、尿8-iso．PGF2。、血钾、血钠等。结果两组治疗前后空腹血糖、餐后2h血糖、收缩压、舒张压、糖化血红蛋白、三酰甘油、LDL-C、血钠比较差异无统计学意义（P〉0．05）。对照组治疗前后ACR、8．iso．PGF2。比较差异无统计学意义（P〉0．05），试验组治疗后ACR、8-iso-PGF2α较治疗前和对照组治疗后均明显降低[（44．55±46．82）mg／g比（85．42±59．46）mg／g和（110．02±110．65）mg／g、（251．07±424．64）ng／L比（438．84±505．23）ng/L和（465．21±544．08）ng／L，P〈0．05]。对照组和试验组治疗后TC均较治疗前明显降低[（4．63±0．87）mmol／L比（5．14±0．98）mmol／L和（4．56±0．80）mmol／L比（4．98±0．98）mmol／L，P〈0．05]，但两组间比较差异无统计学意义（P〉0．05）。试验组治疗后血钾较治疗前明显升高[（4．10±0．46）mmol／L比（3．82±0．46）mmol／L，P〈0．05]。结论螺内酯对糖尿病肾病具有独立的抗氧化和降低ACR的保肾作用。

Objective To explore the effect of spirolactone on urinary 8-iso-prostaglandin F2α （8-iso-PGFα） of diabetic nephropathy patients. Methods Seventy-eight diabetic nephropathy patients were divided into trial group （40 cases） and control group （38 cases） by random digits table method. Control group was treated regularly, and trial group was treated with additional spirolactone 20 mg daily for 3 months. Systolic blood pressure and diastolic blood pressure, fasting plasma glucose,2 h post-prandial plasma glucose, total cholesterol, triglyceride,low density lipoprotein cholestorol, glycosylated hemoglobin, urinary ratio of albumin to creatinine,urinary 8-iso-PGF2~,serum potassium and serum sodium were observed. Results There was no significant differences in FPG, 2 hPG, SBP,DBP, HbAlc,TG, LDL-C and serum sodium before and after treatment in two groups （P〉 0.05）. There was no significant difference in ACR and 8-iso-PGF2α before and after treatment in control group （P 〉 0.05）. ACR and 8-iso-PGF2α were decreased after treatment in trial group compared with those before treatment and compared with those after treatment in control group[（44.55 ±46.82） mg/g vs. （85.42 ±59.46） mg/g and （110.02 ± 110.65） mg/g, （251.07 ±424.64） ng/L vs. （438.84± 505.23 ） ng/L and （465.21 ± 544.08） ng,/L,P 〈 0.05 ]. TC was decreased after treatment compared with that before treatment in control group and trial group [（4.63 ± 0.87） mmol/L vs. （5.14± 0.98） mmol/L and （4.56 ±0.80） mmol/L vs. （4.98 ± 0.98） mmol/L,P 〈 0.05 ] ,but there was no significant difference between two groups （P 〉 0.05 ）. Serum potassium was increased after treatment in trial group compared with that before treatment [ （4.10 ± 0.46） mmol/L vs. （ 3.82 ± 0.46） mmol/L, P 〈 0.05 ]. Conclusion The spirolaetone plays renal protect effect on diabetic nephropathy patients through independent anti-oxidation and lowering ACR.