替米沙坦联合前列地尔对糖尿病肾病氧化应激、免疫炎性反应及肾功能的影响

Effects of telmisartan combined with alprostadil on oxidative stress,immune inflammatory response and renal function in diabetic nephropathy

目的探讨替米沙坦联合前列地尔治疗对糖尿病肾病患者氧化应激、免疫炎性反应及肾功能的影响。方法选择2018年7月—2019年6月遂宁市中心医院内分泌科收治的糖尿病肾病患者92例为研究对象,采用随机数字表法分为试验组48例,对照组44例。对照组给予替米沙坦口服治疗,试验组给予替米沙坦联合前列地尔治疗。治疗4周末,比较2组患者氧化应激、炎性因子、T淋巴细胞亚群、肾功能、不良反应等指标。结果治疗4周后,试验组糖尿病肾病患者血清SOD低于对照组,MDA高于对照组(t/P=4.340/0.023,42.917/0.000);白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hs-CRP)水平明显低于对照组(t/P=8.444/0.000,5.896/0.010,13.241/0.000);CD3^+、CD4^+、CD4^+T细胞及CD8^+比例明显高于对照组,CD8^+T细胞明显低于对照组(t=4.753、5.573、4.020、3.049,P均<0.05);尿素氮(BUN)、胱抑素C(CysC)含量明显低于对照组,肾小球滤过率(eGFR)明显高于对照组(t=4.732,5.704,4.211,P均<0.05)。结论替米沙坦联合前列地尔治疗有助于缓解糖尿病肾病患者氧化应激和炎性反应,改善细胞免疫功能,促进肾功能恢复。

Objective To explore the effect of telmisartan combined with alprostadil on oxidative stress,immune inflammatory response and renal function in diabetic nephropathy.Methods Ninety-two diabetic nephropathy patients admitted to the Endocrinology Department of Suining Central Hospital from July 2018 to June 2019 were selected as the study objects.48 patients in the experimental group and 44 patients in the control group were randomly divided into two groups.The control group was treated with telmisartan orally,and the experimental group was treated with telmisartan combined with alprostadil.At the end of 4 weeks,oxidative stress,inflammatory factors,T lymphocyte subsets,renal function and adverse reactions were compared between the two groups.Result:After 4 weeks of treatment,the serum SOD and MDA of diabetic nephropathy patients in the experimental group were lower than those in the control group(t/P=4.340/0.023,42.917/0.000).The levels of IL-6,TNF-αand hs-CRP in the control group were significantly lower than those in the control group(t/P=8.444/0.000,5.896/0.010,13.241/0.000).The proportion of CD3^+,CD4^+,CD4^+T cells and CD8^+was significantly higher than that of the control group,and CD8^+T cells were significantly lower than that of the control group(t=4.753,5.573,4.020,3.049,P<0.05).The contents of bun and CysC were significantly lower than those of the control group,and the glomerular filtration rate(EGFR)was significantly higher than that of the control group(t=4.732,5.704,4.211,P<0.05).Conclusion Telmisartan combined with alprostadil can alleviate oxidative stress and inflammatory response,improve cellular immune function and promote the recovery of renal function.