硫辛酸对糖尿病肾病Ⅲ期患者PCX和VEGF的影响

Effect of thioctic acid on urinary podocalyxin and plasma VEGF in patients with stage Ⅲ diabetic nephropathy

目的探讨糖尿病肾病(DN)Ⅲ期患者尿足细胞标志蛋白(PCX)及血管内皮生长因子(VEGF)水平的变化及α-硫辛酸(ALA)对其的影响。方法 122例2型糖尿病患者根据24 h尿白蛋白排泄率分为单纯糖尿病组(SDM组)62例、DNⅢ期组(NA组)60例。NA组随机分为ALA治疗组(NAⅠ组30例)和常规治疗组(NAⅡ30例),另选正常对照者(NC组)60例。比较ALA治疗前及治疗2周后丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-px)、尿PCX及血VEGF的变化。结果 NAⅠ组经ALA治疗后MDA、UAER、PCX及VEGF较治疗前下降(P<0.05),SOD及GSH-px较治疗前上升(P<0.05)。结论 ALA可通过抗氧化应激保护DNⅢ期患者肾小球足细胞。

Objective To investigate the changes of urinary podocalyxin(PCX)and vascular endothelial growth factor(VEGF)in the patients with diabetic nephropathy(DN)at stage III and the effect of alpha-lipoic acid(ALA)on them.Methods According to the uriary albumin excretion rate(UAER),182 participants were divided into three groups as:simple diabetes mellitus group(SDM,n=62),DN at stage III group(NA,n=60),and normal control group(NC,n=60).Then the NA group was randomly divided into ALA treatment group(NA I,n=30)and conventional treatment group(NA II,n=30).The levels of MDA,SOD,GSH-px,urinary PCX and serum VEGF were determined at baseline and 2 weeks after treatment.Results The level of MDA after ALA treatment was lower than that before ALA treatment in the NA I group(P<0.05).The levels of SOD and GSH-px were higher than those before treatment(P<0.05).The levels of urinary PCX and serum VEGF were lower after treament(P<0.05).Conclusions ALA can provide some protection against glomerular podocyte injury,which may be related to its effect in alleviating enhanced oxidative stress in DN at stage III.