雷公藤多苷联合百令胶囊保护糖尿病肾病患者足细胞损害

Protective effect of Tripterygium Glycosides combined with Bailing Capsules on podocytes in patients with diabetic nephropathy

目的探讨雷公藤多苷联合百令胶囊(虫草菌丝体)在糖尿病肾病(DN)患者足细胞损害中的保护作用。方法将60例DN患者在接受基础治疗上随机均分为常规治疗组(常规组)、雷公藤多苷组及雷公藤多苷联合百令胶囊治疗组(联合组),观察患者治疗前及3个月后血白蛋白(ALB)、肌酐(Cr)、尿素氮(BUN)、C反应蛋白(CRP)、胱抑素C(Cys C)及24 h尿蛋白定量(UTP)、尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、尿足细胞数及足细胞标志蛋白Podocalyxin(PCX)表达变化情况。结果治疗3月后雷公藤多苷组和联合组患者血24h UTP、尿NGAL均较治疗前有明显下降,其中联合组下降更明显;与常规组治疗后比较,联合组Cys C、CRP、24h UTP、尿NGAL、尿足细胞数及PCX表达量有明显下降;与雷公藤多苷组治疗后比较,联合组BUN、CRP、24h UTP、尿足细胞数及PCX表达量有明显下降。相关分析显示,CRP与足细胞数及PCX表达量呈正相关(r分别为0.742、0.689),PCX表达量与尿NGAL、Cys C呈正相关(r分别为0.387、0.413)。结论雷公藤多苷联合百令胶囊可通过减少足细胞损害更好发挥保护作用,其机制可能与其抑制炎症反应有关。

AIM To investigate the protective effects of tripterygium glycosides combined with Bailing Capsules（ extract of Cephalosporium Sinensis） on podocytes in patients with diabetic nephropathy（ DN）. METHODS Sixty cases of DN patients receiving treatment were randomly divided into routine group,tripterygium glycosides group and tripterygium glycosides combined with Bailing Capsules group（ combined group）. The biochemical indices were observed,including serum albumin（ ALB）,creatinine（ Cr）,blood urea nitrogen（ BUN）,C-reactive protein（ CRP）,Cys C and 24 h urinary protein（ UTP）,urine neutrophil gelatinase associated lipocalin（ NGAL）,urine podocyte number and podocyte marker protein podocalyxin（ PCX） expression changes of patients before and after three months. RESULTS After the treatment,the levels of 24 h UTP and urine NGAL were significantly decreased in the triperygium glycosides group and the combined group; the combined group fell more obviously. Compared with the routine group,the Cys C,CRP,24 h UTP,urine NGAL,the number of podocyte and PCX expression were significantly decreased after the treatment in the combined group. Compared with the tripterygium glycosides group,the BUN,24 h UTP,CRP,the number of podocyte and PCX expression were significantly decreased in thecombined group. Correlation analysis showed that CRP was positively correlated with the number of podocyte and the expression of PCX（ r = 0. 742,0. 689）,PCX expression was positively correlated with urinary NGAL and CysC（ r = 0. 387,0. 413）. CONCLUSION The combination of tripterygium glycosides and Bailing Capsules can protect the renal function by reducing the damage of podocyte,and its mechanism may be related to the inhibition of inflammatory reaction.