雷公藤多苷联合复方α-酮酸对糖尿病肾病肾间质纤维化及氧化应激的影响

Effect of Tripterygium Glycosides Combined with Compound α-Keto Acid on Renal Interstitial Fibrosis and Oxidative Stress in Patients with Diabetic Nephropathy

目的探讨雷公藤多苷联合复方α-酮酸治疗糖尿病肾病(DN)的疗效及对肾间质纤维化及氧化应激的影响。方法选择医院2014年1月至2017年5月收治的DN患者93例,随机分为对照组(46例)和治疗组(47例)。对照组患者给予雷公藤多苷治疗,治疗组患者给予雷公藤多苷联合复方α-酮酸治疗,两组均连续治疗3个月。结果治疗组总有效率为93. 62%,明显高于对照组的78. 26%(χ2=4. 559,P=0. 033)。治疗后,两组患者血肌酐(SCr)、尿素氮(BUN)、胱抑素C(CysC)、24 h尿蛋白定量、血管内皮生长因子(VEGF)、同型半胱氨酸(Hcy)、转化生长因子-β1(TGF-β1)、丙二醛(MDA)、晚期蛋白氧化产物(AOPP)水平相比治疗前均降低,且治疗组降幅更明显(P <0. 05);两组患者肝细胞生长因子(HGF)、超氧化物歧化酶(SOD)及总抗氧化能力(T-AOC)水平相比治疗前均上升,且治疗组升幅更明显(P <0. 05)。两组治疗过程中不良反应发生率比较,差异无统计学意义(χ2=0. 595,P=0. 440)。结论雷公藤多苷联合复方α-酮酸治疗DN的临床疗效显著,能改善肾功能,抑制肾间质纤维化,减轻氧化应激反应,且安全性较好,值得临床推广。

Objective To investigate the clinical effect of tripterygium glycosides combined with compound a- keto acid in the treatment of diabetic nephropathy（DN） and its effect on renal interstitial fibrosis and oxidative stress. Methods Totally 93 patients with DNadmitted to our hospital from January 2014 to May 2017 were selected and randomly divided into the control group（46 cases） and the treatment group（47 cases）. The control group was treated with tripterygium glycosides, while the treatment group was treated with tripterygium glycosides combined with compound a- keto acid. The two groups were treated for 3 months. Results The total eft）ctive rate of the treatment group was 93.62%, which was significantly higher than 78.26% of the control group（χ2 =4. 559, P =0. 033）. After treatment, the levels of serum creatinine（SCr）, blood urea nitrogen（BUN）, cystatin C（CysC）, 24 h urinary protein quantification, vascular endothelial growth factor （VEGF）, homocysteine （Hey）, transforming growth factor - [31 （TGF - [31）, malondialdehyde （MDA） and advanced oxidation protein products（AOPP） in the two groups were lower than those before treatment, and the decrease in the treatment group was more significant（ P 〈 0. 05）. While the levels of hepatocyte growth factor（HGF）, superoxide dismutase（SOD） and total antioxidant capacity（T-AOC） in the two groups were higher than those before treatment, and the increase in the treatment group was more significant（ P 〈 0. 05）. There was no significant dift）rence in the incidence rate of adverse reactions between the two groups（χ2=0.595, P=0.440）. Conclusion Tripterygium glycosides combined with compound a-keto acid is eft）ctive in the treatment of DN, it can improve renal function, inhibit renal interstitial fibrosis and reduce oxidative stress. It is safe and worthy of clinical promotion.