低蛋白饮食配合药物治疗对早期糖尿病肾病患者肾功能及氧化-抗氧化平衡的影响研究

Study on Effect of Low Protein Diet Combined with Drugs Treatment on the Renal Function and Oxidation Antioxidant Balance of Patients with Early Diabetic Nephropathy

目的探讨低蛋白饮食联合药物治疗对早期糖尿病肾病患者肾功能、氧化-抗氧化平衡的影响。方法选取该院2017年1月—2018年1月收治的早期糖尿病肾病患者100例为研究对象,均经临床检查确诊,根据不同治疗方法分为两组,对照组(n=50)给予常规药物治疗,观察组(n=50)在对照组基础上给予低蛋白饮食,对比两组患者治疗前后肾功能指标、氧化产物指标、抗氧化指标以及尿液中足细胞损伤标志物。结果治疗后观察组患者Hcy、CysC、Scr、BUN水平分别为(9.0±1.0)mmol/L、(1.14±0.15)mg/L、(106.4±15.3)μmol/L、(7.5±0.8)mmol/L,明显低于对照组(12.5±1.7)mmol/L、(1.88±0.24)mg/L、(130.6±15.3)μmol/L、(9.7±1.2)mmol/L,差异有统计学意义(t=12.548 1、18.488 4、7.908 5、10.786 4,P<0.05)。治疗后观察组患者T-AOC、SOD、CAT水平分别为(35.2±3.7)U/L、(99.5±10.1)U/L、(44.0±5.4)U/L,明显高于对照组(26.9±2.3)U/L、(77.4±8.5)U/L、(37.8±3.5)U/L,AOPP、MDA水平(20.4±1.1)μmol/L、(9.0±1.1)μmol/L,明显低于对照组(25.7±2.1)μmol/L、(11.4±1.4)μmol/L,差异有统计学意义(t=13.471 5、11.838 0、6.812 8、15.808 6、9.531 6,P<0.05)。治疗后观察组患者podocinde、nephrin、ZO-1、α-actinin-4的mRNA表达量分别为(0.53±0.07)、(0.65±0.06)、(0.59±0.06)、(0.66±0.10),明显低于对照组(0.72±0.07)、(0.82±0.11)、(0.79±0.09)、(0.84±0.10),差异有统计学意义(t=13.571 4、9.593 7、13.074 4、9.000 0, P<0.05)。结论低蛋白饮食联合药物治疗对早期糖尿病肾病患者肾功能、氧化-抗氧化平衡具有积极的作用,值得临床推广。

Objective To study the effect of low protein diet combined with drugs treatment on the renal function and oxidation antioxidant balance of patients with early diabetic nephropathy.Methods 100 cases of patients with early diabetic nephropathy admitted and treated in our hospital from January 2017 to January 2018 were selected and confirmed by the clinical examination,and the patients were divided into two groups according to different treatment methods,with 50 cases in each,the control group used the routine drugs,while the observation group were given the low protein diet on the basis of the control group,and the renal function indicators,indicators of oxidative products,antioxidant indices and markers of podocyte injury in urine were compared between the two groups.Results After treatment,the Hcy,CysC,Scr,BUN levels in the observation group were obviously lower than those in the control group[(9.0±1.0)mmol/L,(1.14±0.15)mg/L,(106.4±15.3)μmol/L,(7.5±0.8)mmol/L vs(12.5±1.7)mmol/L,(1.88±0.24)mg/L,(130.6±15.3)μmol/L,(9.7±1.2)mmol/L],and the differences were statistically significant(t=12.548 1,18.488 4,7.908 5,10.786 4,P<0.05),after treatment,the T-AOC,SOD,CAT levels in the observation group were obviously higher than those in the control group[(35.2±3.7)U/L,(99.5±10.1)U/L,(44.0±5.4)U/L vs(26.9±2.3)U/L,(77.4±8.5)U/L,(37.8±3.5)U/L],and the AOPP,MDA levels were obviously lower than those in the control group[(20.4±1.1)μmol/L,(9.0±1.1)μmol/L vs(25.7±2.1)μmol/L,(11.4±1.4)μmol/L],and the differences were statistically significant(t=13.471 5,11.838 0,6.812 8,15.808 6,9.531 6,P<0.05),after treatment,the mRNA expression amounts of podocinde,nephrin,ZO-1,α-actinin-4 in the observation group were obviously lower than those in the control group[(0.53±0.07),(0.65±0.06),(0.59±0.06),(0.66±0.10)vs(0.72±0.07),(0.82±0.11),(0.79±0.09),(0.84±0.10)],and the differences were statistically significant(t=13.571 4,9.593 7,13.074 4,9.000 0,P<0.05).Conclusion The effect of low protein diet combined with drugs treatment on the renal function and oxidation antioxidant balance of patients with early diabetic nephropathy is positive,which is worth promotion.