舒洛地特联合高通量血液透析对糖尿病肾病患者血清Angptl4和Vaspin水平的影响

Effects of sulodexide combined with high flux hemodialysis on serum Angptl4 and Vaspin levels in patients with diabetic nephropathy

目的:探讨舒洛地特联合高通量血液透析对糖尿病肾病(DN)患者血清血管生成素样蛋白4(Angptl4)及脂肪特异性丝氨酸蛋白酶抑制剂(Vaspin)表达的影响。方法:将2013年1月至2016年1月在湖北省襄阳市中心医院就诊的116例DN患者随机分为对照组和观察组,每组58例。对照组采用高通量血液透析治疗,观察组在对照组基础上口服舒洛地特。比较两组治疗前、后血清肌酐(Scr)、尿素氮(BUN)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α)、Angptl4和Vaspin水平,以及全血高切黏度(HBV)、全血低切黏度(LBV)、血浆黏度(PV)和纤维蛋白原(FIB)浓度。结果:治疗后,观察组Scr、BUN、HBV、LBV、PV、FIB、CRP、IL-6和TNF-α水平均显著低于对照组(P<0.05),血清Angptl4和Vaspin水平均显著高于对照组,差异均具有统计学意义(P<0.05)。结论:舒洛地特联合高通量血液透析能降低DN患者血液黏度,提高血清Angptl4和Vaspin水平,并减轻炎症反应。

Objective：To investigate the effects of sulodexide combined with high flux hemodialysis on serum angiopoietin-like protein 4（Angptl4）and adipose-specific serine protease inhibitor Vaspin levels in patients with diabetic nephropathy（DN）.Methods：A total of 116 DN patients in our hospital from January 2013 to January 2016 were selected,and randomly assigned to receive either high flux hemodialysis treatment（control group,n=58）or sulodexide combined with high flux hemodialysis（observation group,n=58）.The serum creatinine（Scr）,urea nitrogen（BUN）,C-reactive protein（CRP）,interleukin-6（IL-6）,tumor necrosis factor（TNF-α）,Angptl4 and Vaspin levels as well as the high blood viscosity（HBV）,low blood viscosity（LBV）,plasma viscosity（PV）and fibrinogen（FIB）content were compared.Results：After treatment,the Scr,BUN,HBV,LBV,PV,FIB,CRP,IL-6 and TNF-αlevels in the observation group were significantly lower than those in the control group（P〈0.05）,while the serum levels of Angptl4 and Vaspin were notably higher（P〈0.05）.Conclusion：Sulodexide combined with high flux hemodialysis could effectively reduce blood viscosity,increase serum Angptl4 and Vaspin levels and alleviate inflammatory reaction in DN patients.