血栓通与贝那普利对早期糖尿病肾病炎症因子的影响

Comparison of Effects of Compound Xueshuantong Capsule and Benazepril on Serum Inflammatory Cytokines in Early Diabetic Nephropathy

目的比较复方血栓通胶囊与贝那普利对早期糖尿病肾病(DN)炎症因子的影响,探讨其治疗早期DN的机制。方法 2型糖尿病患者94例,其中无蛋白尿糖尿病(DM)组24例,早期DN组70例,DN组又随机分为A组24例,B组22例,C组24例,A组给予盐酸贝那普利(10 mg/次,1次/d),B组给予复方血栓通胶囊(3粒/次,3次/d),C组联合应用复方血栓通和盐酸贝那普利,共观察3个月。观察各组患者治疗前后空腹血糖、糖化血红蛋白、血脂、肾功能、纤维蛋白原及尿白蛋白排泄率(UAER)的变化,同时测定血清高敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平。结果 DN各组血清hs-CRP、IL-6、TNF-α水平明显高于DM组(P<0.01);与治疗前比较,DN各组患者UAER、hs-CRP、IL-6、TNF-α均明显降低(P<0.01),其中C组下降更明显;C组血脂、纤维蛋白原与A组、B组比较明显降低(P<0.01)。结论复方血栓通胶囊联合贝那普利不仅可以改善DN患者的血脂及高凝状态,还可能通过降低血清hs-CRP、IL-6、TNF-α的表达,抑制炎症反应,达到对DN的保护作用。

Objective To compare effects of compound Xueshuantong capsule and benazepril on inflammatory cyto-kines in type 2 diabetic patients with early diabetic nephropathy （DN）, and its therapeutic mechanism thereof. Methods Ninety-four patients with type 2 diabetes were divided into diabetes without albuminuria group （DM,n=24） and early DN group （DN,n=70）. DN group was then divided into three subgroups：group A （n=24） treated by benazepril alone, group B （n=22） treated by compound Xueshuantong capsule and group C （n=24） treated by compound Xueshuantong capsule combined with benazepril for 3 months. Levels of fasting blood glucose, glycosylated hemoglobin, serum creatinine, blood urea nitro-gen, lipid profiles, fibrinogen and urinary albumin excretion rate （UAER） were examined before and after treatment. The se-rum levels of hypersensitive c-reactive protein （hs-CRP）, interleukin-6 （IL-6） and tumor necrosis factor-α（TNF-α） were determined as well. Results The serum levels of hs-CRP, IL-6 and TNF-αwere significantly higher in DN group than those of DM group （P〈0.01）. After treatment, the serum levels of UAER, hs-CRP, IL-6 and TNF-αwere significantly re-duced in groups A, B and C compared with those before treatment （P〈0.01）, and which were decreased more significantly in group C. The levels of blood lipids and fibrinogen decreased obviously in group C compared with those of group A and B （ P〈0.01）. Conclusion Compound Xueshuantong capsule combined with benazepril not only can improve the blood fat and high coagulation state in patients, but also impossibly retard the development of early DN through decreasing serum concen-trations of hs-CRP, IL-6 and TNF-αand inhibiting inflammatory reaction.