早期糖尿病肾病患者应用硫辛酸治疗对其氧化应激反应及微量白蛋白排泄机制的影响

Influence of Lipoic Acid Therapy in Treatment of Patients with Early Diabetic Nephropathy for Mechanism of Oxidative Stress Response and Microalbumin Excretion Mechanism

目的探讨早期糖尿病肾病患者应用硫辛酸治疗对其氧化应激反应及微量白蛋白(mAlb)排泄机制的影响。方法抽取某院2015年1月-2016年12月收治的60例糖尿病肾病患者,依随机数字表原则将其分为对照组30例与研究组30例,2组患者均接受常规胰岛素降糖、降血压、降血脂等治疗,研究组患者在原有治疗基础上增加硫辛酸注射液治疗,连续治疗2周。治疗前后采集2组患者晨起空腹静脉血,对其血糖浓度、MDA含量、SOD活性进行测定,并留24h尿液样本测其mAlb水平。结果治疗后研究组患者空腹血糖与HbA1c含量为6.7±1.5mmol/L与6.2±1.4%,显著比对照组的7.8±1.7mmol/L与7.2±1.8%更低;对照组患者MDA含量、SOD活性、24h尿mAlb与治疗前无明显变化;治疗后研究组MDA含量、24h尿mAlb均显著下降,SOD活性显著上升,均具有显著差异。结论早期糖尿病肾病患者应用硫辛酸治疗可显著减少患者尿液中微量白蛋白水平,使机体氧化应激状态得到显著改善,保护肾脏功能,为临床DN的抗氧化治疗提供新的治疗依据。

Objectives To probe into the influence of lipoic acid in treatment of early diabetic nephropathy for mechanism of oxidative stress response and Microalbumin（mAlb） excretion mechanism.Methods 60 cases of patients with diabetic nephropathy and who treated in our hospital from January,2015 to December,2016 were selected and were divided into control group 30 cases and study group 30 cases according to the principle of random number table. Two groups were received routine insulin lowering sugar,lowering blood pressure and lowering blood fat. The study group were treated with Thioctic Acid Injection therapy on the basis of the original treatment,and the continuous treatment for 2 weeks. Then,two groups of patients with fasting venous blood were collected in the morning before and after treatment,and the blood glucose concentration,MDA content and SOD activity were measured,the mAlb level was measured with 24 h urine samples.Results After the treatment,the fasting blood glucose and HbA1c content in the study group were 6.7±1.5 mmol/L,6.4±1.4%,which was significantly lower than those in the control group of 7.8±1.7 mmol/L,7.2±1.8%.There was no significant change in MDA content,SOD activity and 24 h urine mA lb in the control group;After the treatment,the content of MDA and the mAlb of 24 h urine in the study group were significantly decreased,and the activity of SOD were significantly increased.Conclusions The application of lipoic acid in treatment of early diabetic nephropathy which can significantly reduce the level of microalbumin in urine of the patients,and can improve the oxidative stress of the body significantly,protect the function of the kidney,and provide a new treatment basis for the antioxidation treatment clinical of DN.