西洛他唑联合替米沙坦对早期2型糖尿病肾病血清单核细胞趋化蛋白1和可溶性细胞间黏附分子1的影响

The Effect of Cilostazol Combined with Telmisartan on Serum Monocyte Chemotactic Protein-1 and Soluble Intercellular Adhesion Molecule-1 in Early Type 2 Diabetic Nephropathy

目的观察西洛他唑联合替米沙坦对早期2型糖尿病肾病(diabetic nephropathy,DN)血清单核细胞趋化蛋白1(MCP-1)和可溶性细胞间黏附分子1(s ICAM-1)的影响。方法将我院收治的早期2型DN 60例随机分为西洛他唑联合替米沙坦组和替米沙坦组两组各30例,在常规治疗基础上西洛他唑联合替米沙坦组予西洛他唑和替米沙坦治疗,替米沙坦组仅予替米沙坦治疗,观察比较两组治疗前及治疗4周后24 h尿微量白蛋白、血压及血清MCP-1、s Ic AM-1、丙氨酸转氨酶、肌酐、糖化血红蛋白水平。结果治疗4周后,两组24 h尿微量白蛋白及血清MCP-1、s Ic AM-1均较治疗前明显下降,差异有统计学意义(P<0.05);西洛他唑联合替米沙坦组24 h尿微量白蛋白及血清MCP-1、s Ic AM-1均明显低于替米沙坦组,差异亦有统计学意义(P<0.05)。结论西洛他唑联合替米沙坦可减少早期2型DN患者尿白蛋白排出,保护肾脏,延缓疾病进展,且临床应用相对安全。

Objective To observe the effect of cilostazol combined with telmisartan on serum monocyte chemotactic pro-tein-1 （MCP-1） and soluble intercellular adhesion molecule-1 （sICAM-1） in early type 2 diabetic nephropathy. Methods A total of 60 patients with early type 2 diabetic nephropathy were randomly divided into two groups：thirty patients in group A were treated with cilostazol and telmisartan based on routine treatment, while thirty patients in group B were treated with telmisartan a-lone. The levels of 24-h urinary albumin, blood pressure, MCP-1, sICAM-1, alanine aminotransferase, creatinine and glycosy-lated hemoglobin in two groups were compared before treatment and 4 weeks after treatment. Results The levels of 24-h urinary albumin, MCP-1 and sICAM-1 were significantly decreased in both groups after treatment for four weeks, and the differences were significant （P〈0. 05）. After treatment, the levels of 24-h urinary albumin, MCP-1 and sICAM-1 in group A were obvious-ly lower than those in group B （P〈0. 05）. Conclusion Cilostazol combined with telmisartan can significantly decrease the uri-nary albumin level in the patients with early type 2 diabetes nephropathy, it can protect the kidney, and delay the progression of early diabetic nephropathy. It is relatively safe in clinical application.