注射用丹参多酚酸盐在早期糖尿病肾病治疗中的应用

Salvianolate Injection in the Early Treatment of Diabetic Nephropathy

目的探讨注射用丹参多酚酸盐对早期糖尿病肾病(DN)的治疗作用。方法将2011年1月至2014年1月深圳市南山区西丽人民医院收治的84例早期DN患者按照随机数字表法分为两组,每组42例。对照组采用控制血压、血糖、血脂等常规治疗;观察组在对照组治疗基础上采用丹参多酚酸盐静脉滴注,每次200 mg,每日1次,连续治疗14 d。比较两组患者治疗前后血清高敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、可溶性细胞间黏附分子1(s ICAM-1)、血内皮素1(ET-1)的水平,并比较治疗前后两组尿蛋白排泄率(UAER)及血清β2微球蛋白(β2-MG)水平。结果两组治疗前血清hs-CRP、IL-6、TNF-α、s ICAM-1及ET-1水平比较差异无统计学意义(P>0.05),治疗后两组上述血清学指标均较治疗前下降(P<0.01),且观察组低于对照组(P<0.01);两组治疗前UAER、血清β2-MG水平比较差异无统计学意义(P>0.05),治疗后两组上述肾功能指标均较治疗前下降(P<0.01),且观察组低于对照组(P<0.01)。结论注射用丹参多酚酸盐应用于早期DN的治疗可改善肾血管内皮细胞功能,利于保护肾脏功能,延缓DN的进展,其机制可能与抑制炎性因子的分泌和表达有关。

Objective To investigate the effect of salvianolate injection on early diabetic nephropathy （ DN） .Methods A total of 84 patients with early DN admitted to Xili People′s Hospital of Nanshan District were divided into two groups according to random number table method ,with 42 cases in each group.The con-trol group was treated with blood pressure,blood glucose,blood lipid control therapy and other conventional treatments;the observation group was treated with salvianolate intravenous drip based on the treatment of the control group,200 mg each time,1 time a day,continuously for 14 days.Serum high sensitivity C reactive pro-tein （hs-CRP）,interleukin-6 （IL-6）,soluble cell intercellular adhesion molecule-1（sICAM-1） and plasma endothelin-1（ET-1） tumor necrosis factor alpha（TNF-α）,level of the two groups were compared before and after treatment,and urinary albumin excretion rate （ UAER） and serum β2 microglobulin （β2-MG） level before and after treatment were compared too .Results There were no statistically significant differences in serum hs-CRP,IL-6,TNF-α,sICAM-1 and ET-1 levels before treatment between the two groups（P〉0.05）, which all decreased after treatment than before treatment （ P〉0.01 ） , and the observation group was lower than the control group（P〈0.01）;There were no statistically significant differences in UAER,serum β2-MG level before treatment between the two groups （ P〉0.05 ） , which all decreased after treatment than before treatment （ P〈0.01 ） ,and the observation group was lower than the control group （ P〈0.01 ） .Conclusion The application of salvianolate injection on early DN treatment can improve vascular endothelial cell func-tion,which is conducive to protect renal function,delay the progress of DN.Its mechanism may be related to inhibiting the secretion and expression of inflammatory cytokines .