依帕司他对早期糖尿病肾病患者尿足细胞相关蛋白nephrin表达的影响

Effect and Mechanism of Epalrestat on Urinary Podocyte Related Protein Nephrin Expression in Early Type 2 Diabetic Nephropathy Patients

目的研究依帕司他对早期2型糖尿病肾病尿足细胞相关蛋白nephrin表达的影响。方法将52例2型早期糖尿病肾病患者随机分为对照组和治疗组,对照组给予常规治疗,治疗组在对照组的基础上口服依帕司他胶囊(50mg,3次/日),疗程12周。在治疗前后测患者血压、血糖、血脂、糖化血红蛋白、血清肌酐及尿白蛋白排泄率(UAER)。采用酶联免疫吸附法测定两组患者尿液中TGF-β1和尿nephrin表达。结果依帕司他治疗前后患者血糖、血脂、血压、血清肌酐变化,差异无统计学意义(P>0.05)。治疗后两组患者UAER与治疗前相比差异有统计学意义(P<0.05),且治疗组UAER与对照组相比,差异有统计学意义(P<0.05)。与对照组相比,治疗组TGF-β1和nephrin差异有统计学意义(P<0.05)。结论依帕司他可减少早期糖尿病肾病患者尿nephrin表达,该途径可能是通过抑制TGF-β1的表达实现的。

Objective To observe the effect and mechanism of epalrestat on urinary podocyte related protein nephrin expression in early diabetic nephropathy patients. Methods Fifty two type 2 diabetic nephropathy patients were divided into control group and treatment group （epalrestat 50mg 3 times a day for 12 weeks）. Before and after the treatment, Blood pressure, blood glucose, blood lipid, glycosylated hemoglobin, serum creatinine and urinary albumin excretion rate （UAER） were measure in both groups. Meanwhile, urinary TGF - β1 and nephrin were determined by ELISA assay. Results After treatment,blood glucose, blood lipid,blood pressure, glycosylated hemoglobin and serum creatinine remained stable（P 〉0.05） , and a significant decrease in UAER was observed in epalrestat group after treatment （ P 〈 O. 05 ）. Compared with the control group, the levels of TGF - β1 and nephrin were obviously descended after administration of epalrestat. Conclusion Epalrestat could reduce the expression of urinary nephrin in early type 2 diabetic nephropathy patients, which might be through inhibiting the expression of TGF - β1.