羟苯磺酸钙治疗慢性移植肾肾病的疗效和机制研究

Effect and mechanism of calcium dobesilate in the treatment of chronic allograft nephropathy

目的观察羟苯磺酸钙对慢性移植肾肾病的作用及可能的机制。方法将66例慢性移植肾肾病患者随机分为对照组和治疗组。两组均使用常规综合治疗,治疗组加用羟苯磺酸钙胶囊(500mg/次,3次/d),对照组继续维持常规治疗方案,两组患者均治疗3个月。观察2组患者治疗前、后测血肌酐、肌酐清除率、24h尿总蛋白、血ET-1和尿TGF-β1浓度的变化。结果治疗3个月后,治疗组较治疗前及同期对照组血肌酐、血ET-1和尿TGF-β1浓度明显下降,而肌酐清除率明显升高(P<0.05);治疗组24h尿总蛋白较治疗前和同期对照组无明显差异(P>0.05)。结论羟苯磺酸钙对CAN有一定疗效,且其机制可能与降低TGF-β1和ET-1水平有关。

Objective To study the effect of calciumdobesilate on CAN and to explore its potential mechanism. Methods 66 patients were randomly assigned to 2 groups：control group and treatment group. Routine treatment was maintained in the two groups. Based on the control group,treatment group were given oral calcium dobesilate each 0.5 g,three times a day. Two groups were treated for 3 months. The changes of serum creatinine,creatinine clearance rate,24 h total protein,blood ET-1 and urinary TGF-beta 1 concentration were observed before and after treatment in the two groups. Results After 3 months of treatment,the serum creatinine,blood ET-1 and urinary TGF-beta 1 concentration in treatment group were significantly decreased and creatinine clearance rate was increased significantly compared with before treatment and the same period of control group（P〈0.05）. There was no significant difference in 24Upro between the treatment group and the control group before and after treatment（P〈0.05）. Conclusion Calcium dobesilate can delay the progression of CAN,and its mechanism may be related to the reduction of TGF-beta 1 and ET-1 levels.