糖尿病肾病患者接受酮酸联合低蛋白饮食后氧化应激损伤程度、RAS活性、足细胞脱落情况的评估

Assessment of the degree of oxidative stress injury,renin-angiotensin system activity and podocyte loss after combined treatment of keto acid and low protein diet for patients with diabetic nephropathy

目的:分析糖尿病肾病患者接受酮酸联合低蛋白饮食后氧化应激损伤程度、RAS活性、足细胞脱落情况。方法:选取在本院接受住院治疗的糖尿病肾病患者106例作为研究对象,随机分为观察组及对照组各53例。对照组接受单纯低蛋白饮食治疗,观察组接受酮酸联合低蛋白饮食治疗,对比两组氧化应激损伤程度、RAS活性、足细胞脱落情况差异。结果:观察组治疗后血清MDA及AOPP水平低于对照组,SOD及T-AOC水平高于对照组(P<0.05);观察组治疗后PRA、AngⅡ、Aldosterone水平低于对照组(P<0.05);观察组治疗后尿沉渣podocin及synaptopodin mRNA表达量低于对照组(P<0.05)。结论:糖尿病肾病患者接受酮酸联合低蛋白饮食治疗,可以降低机体氧化应激损伤程度及RAS活性,减少足细胞脱落,优化患者病情。

Objective.. To analyze the degree of oxidative stress injury, renin-angiotensin system （RAS） activity and podocyte loss after patients with diabetic nephropathy received keto acid combined with low protein diet. Methods： A total of 106 cases of patients with diabetic nephropathy who were admitted to the hospital were selected as research subjects and randomly divided into observation group and control group, each group with 53 cases. Control group received low protein diet treatment alone, while observation group received keto acid combined with low protein diet treatment, and then the degree of oxidative stress injury, RAS activity and podocyte loss of two groups were compared. Results- Serum methane dicarboxylic aldehyde （MDA） and advanced oxidation protein product （AOPP） levels of observation group after treatment were lower than those of control group, and levels of superoxide dismutase （SOD） and total antioxidant capacity （T-AOC） were higher than those of control group （P〈0.05） ; plasma renin activity （PRA）, angiotensin （Ang） Ⅱ and aldosterone levels of observation group after treatment were lower than those of control group （P〈0.05） ; mRNA expression levels of podocin and synaptopodin in urine sediment of observation group after treatment were lower than those of control group （P〈0. 05）. Conclusion： Combined treatment of keto acid and low protein diet for patients with diabetic nephropathy can reduce the degree of oxidative stressinjury and RAS activity, decrease podocyte loss and optimize patients＇ condition.