α硫辛酸对早期糖尿病肾病患者氧化应激水平的影响及对肾脏的保护作用

Alpha.lipoic acid oxidative stress levels in patients with early diabetic nephropathy

目的观察抗氧化剂Ot硫辛酸对早期糖尿病肾病患者氧化应激水平的影响及对肾脏的保护作用。方法采用随机数字表将80例早期糖尿病肾病患者随机分为观察组（40例）和对照组（40例），另从门诊体检中心选择30例健康人为健康组。对照组给予常规治疗；观察组在常规治疗的基础上加用Ot硫辛酸0．6g／次，1次／d静脉滴注，疗程3周；健康组不采取任何治疗。分别测定观察组和对照组治疗前后及健康组丙二醛（MDA）、血清晚期蛋白氧化产物（AOPPs）、血浆超氧化物歧化酶（SOD）和24h尿白蛋白排泄率（UAER）。结果对照组和观察组治疗前较健康组血浆MDA[（5．8±2．1）、（5．6±2．3）／xmol／L比（3．8±0．9）Izmol／L]、AOPPs[（69．44-10．9）、（69．24-11．1）p^mol／L比（22．6±2．9）μmol／L】、24hUAER[（2744-33），（270±46）mg／24h比（12±4）mg／24h]明显升高，SOD[（47±4）、（47±4）U／ml比（744-4）U／m1]较健康组明显降低，差异均有统计学意义（均P〈0．05）。对照组治疗3周后MDA、AOPPs、SOD、24hUAER与治疗前比较差异无统计学意义（P〉0．05）；观察组治疗后MDA、AOPPs、24hUAER较治疗前下降[分别为：MDA为（2．7±1．9）Ixmol／L比（5．6±2．3）μmol／L，AOPPs为（61．7±12．6）p,mol／L比（69．2±11．1）I．Lmol／L]，24hUAER为（183．4-42）mg／24h比（270±46）mg／24h，SOD较治疗前[（52±4）U／ml比（474-4）U／m1]升高，治疗后各指标与治疗前比较差异有统计学意义（P〈0．05）。结论氧化应激在糖尿病肾病的发生发展中起重要作用。0【硫辛酸能降低糖尿病患者氧化应激水平，延缓糖尿病肾病进展。

Objective To observe alpha-lipoic acid（ALA） oxidative stress levels in patients with early dia- betic nephropathy and the influence of the renal protective effect. Methods Eighty early diabetic nephropathy pa- tients were randomly divided into experimental group and control group with 40 cases in each group. In addition, 30 healthy people were as a normal group. The control group was given elementary treatment; the experimental group was additionally given ALA 0.6 g by inrtavenous drip infusion once a day. Both treatments lasted for 3 weeks. The blood level of malondialdehyde （ MDA ）, advanced oxidation protein products （ AOPPs ）, super oxide dismutase （SOD） and 24 h urinary albumin excretion rate （UAER）were compared before and after treatment. Results The blood level of MDA [ （5.8 ＋ 2.1 ）, （5.6 ＋ 2.3 ） p±mol/L vs （ 3.8 ± 0.9 ） I±mol/L ], AOPPs [ （ 69.4 ＋ 10.9 ）, （69.2 ± 11.1 ） txmol/L vs （22.6 ± 2.9 ） I.Lmol/L ], 24 h UAER [ （274 ＋ 33 ）, （ 270 ± 46） mg/24 h vs （ 12 ± 4） mg/24 h ] were significantly increased and the level of SOD E （47：1：4 ）, （47 ± 4 ） U/ml vs （74 ± 4） U/ml ] was ob- viously reduced （ P 〈 0.05 ） in both groups compared with normal control group before treatment. There were no si- gificant differences in MDA, AOPPs, SOD, 24 h UAER in the control group（ P 〉 0.05 ）, but in experimental group MDA [ （2.7 ± 1.9） μmo]/L vs （5.6 ± 2.3 ） μmol/L ], AOPPs [ （61.7 ± 12.6） μmol/L vs （69.2 ± 11.1 ） μmol/L ], 24 h UAER [ （ 183 ＋ 42 ） mg/24 h vs （ 270 ＋ 46 ） mg/24 h ] were significantly decreased and SOD [ （ 52 ＋ 4 ） U/ml vs （47 ± 4 ） U/ml ] was significantly increased （ P 〈 0.05 ） compared with before treatment. Conclusions Oxidative stress in diabetic nephropathy plays an important role in the development. ALA can reduce the level of oxidative stress in diabetes and slow the progress of diabetic nephropathy.