丹参多酚酸盐对老年DN患者MCP-1、TGF-β_1及周围神经传导速度的影响

Effect of Salvianolate on MCP-1,TGF-β_1,and Peripheral Nerve Conduction Velocity in Elderly Patients with Diabetic Nephropathy

目的:探讨丹参多酚酸盐对老年糖尿病肾病(DN)合并周围神经病变患者单核细胞趋化蛋白-1(MCP-1)、转化生长因子-β_1(TGF-β_1)及周围神经传导速度的影响。方法:选取老年DN患者60例为研究对象,随机分为观察组和对照组;对照组给予控制血糖、血压及营养神经等治疗,观察组在对照组基础上联合丹参多酚酸盐静脉滴注;采集两组DN患者治疗前后外周静脉血及尿液标本,采用放免法测定血TGF-β_1及尿MCP-1、TGF-β_1;ELISA法测定血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、一氧化氮(NO)、可溶性细胞间黏附分子-1(s ICAM-1)、内皮素-1(ET-1)水平;肌电图仪测定治疗前后肢体运动神经传导速度(MNCV)和感觉神经传导速度(SNCV)。结果:2组DN患者治疗后血TGF-β_1及尿MCP-1、TGF-β_1水平较治疗前降低(P<0.05),观察组治疗后血TGF-β_1及尿MCP-1、TGF-β_1水平明显低于对照组(P<0.05);观察组DN患者治疗后IL-6、TNF-α、s ICAM-1、ET-1水平较治疗前降低(P<0.05),NO较治疗前升高(P<0.05),对照组上述指标与治疗前比较无明显变化(P>0.05);2组N患者治疗后MNCV、SNCV较治疗前增加(P<0.05);观察组MNCV、SNCV大于对照组(P<0.05)。结论:丹参酚酸盐对老年DN合并周围神经病变患者TGF-β_1、MCP-1具有良好的调节作用,可有效降低炎性细胞因子水平,提高周围神经传导速度。

Objective： To explore the effect of salvianolate on MCP-1, TGF-131, and peripheral nerve conduction velocity in elderly patients with diabetic nephropathy （DN）. Methods： A total of 60 elder- ly patients with DN were included in the study and randomized into the observation group and control group. The patients in the control group were given blood sugar and blood pressure control, nerve trophic drug intervention. On this basis, the patients in the observation group were given salvianolate, ivdrip. After 4-week treatment, the efficacy was evaluated. The morning fasting peripheral venous blood and urine specimens before and after treatment in the two groups were collected. Radioimmuno- assay was used to detect the serum TGF-β1 and urine MCP-1 and TGF-β1. ELISA was used to detect the serum IL-6, TNF-a, NO, sICAM-1, and ET-1 levels. EMG was used to detect MNCV and SNCV. Results： The serum TGF-β1 , urine MCP-1 and TGF-β1, levels after treatment in the two grouos werelower than thosebefore treatment, and those in the observation group were significantly lower than those in the control group （P 〈 0.05）. IL-6, TNF-a, sICAM-1, and ET-1 levels after treatment in the ob- servation group were significantly reduced when compared with before treatment （ P 〈 O. 05 ）, but NO was significantly elevated （ P 〈 0.05 ） , while the above indicators in the control group didn＇ t signifi- cantly change （ P 〉 0.05 ）. MNCV and SNCV after treatment in the observation group were significant- ly greater than those in the control group （ P 〈 0.05 ）. Conclusions ： Salvianolate can effectively regu- late TGF-13~ and MCP-1 levels in elderly patients with DN to protect the kidney, reduce the inflamma- tory cytokine levels, and enhance the peripheral nerve conduction velocity.