α硫辛酸辅助奥美沙坦酯对糖尿病肾病患者血清miR-150-5p及miR-155-5p表达的影响

Effects ofαLipoic Acid-Assisted Olmesartan Medoxomil on Serum miR-150-5p and miR-155-5p Expression in Patients with Diabetic Nephropathy

目的探讨α硫辛酸辅助奥美沙坦酯治疗糖尿病肾病患者的疗效及对血清miR-150-5p及miR-155-5p表达的影响。方法选取2016年1月—2019年1月浙北明州医院收治的144例糖尿病肾病患者,并按照随机数字表法将其分为对照组和观察组,每组72例。2组患者在常规治疗基础上均使用奥美沙坦酯治疗,观察组在对照组基础上加用α硫辛酸治疗,对比2组的治疗临床疗效以及2组患者治疗前后的血糖及波动水平、氧化水平、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、尿蛋白排泄率(urinary protein excretion rate,UAER)、尿β2微球蛋白(β2-microglobulin,β2-MG)、血清miR-150-5p及miR-155-5p的变化。结果观察组的总有效率为86.11%,对照组的总有效率为72.22%,观察组的总有效率高于对照组,差异有统计学意义(P<0.05)。观察组的血糖及波动水平、氧化水平、hs-CRP,UAER,β2-MG的改善情况均显著优于对照组(均P<0.05)。治疗1个月后的血清miR-150-5p及miR-155-5p表达量均低于治疗前(P<0.05),且观察组治疗1个月后血清miR-150-5p及miR-155-5p表达量降低幅度明显优于对照组(P<0.05)。结论α硫辛酸辅助奥美沙坦酯治疗能提高早期糖尿病肾病的临床疗效,可改善外周血血糖水平,降低血糖波动,缓解机体氧化反应,减少炎症反应,降低miR-150-5p和miR-155-5p表达,值得临床进一步研究并推广。

OBJECTIVE To explore the effect ofαlipoic acid-assisted olmesartan medoxomil on patients with diabetic nephropathy and the expression of serum miR-150-5p and miR-155-5p.METHODS The 144 patients with diabetic nephropathy admitted to Zhebei Mingzhou Hospital from January 2016 to January 2019 were enrolled.The patients were divided into control group and observation group according to the random number table method,72 cases in each group.The patients in both groups were treated with olmesartan medoxomil based on routine treatment.The observation group was treated withαlipoic acid on the basis of the control group.The clinical efficacy of the two groups was compared,as well as the blood glucose and fluctuation levels and oxidation level before and after treatment,high-sensitivity C-reactive protein(hs-CRP),urinary protein excretion rate(UAER),changes in urinaryβ2 microglobulin(β2-MG),serum miR-150-5p and miR-155-5p.RESULTS The total effective rate of observation group was 86.11%.The total effective rate of the control group was 72.22%.The total effective rate of the observation group was higher than that of the control group.The difference was statistically significant(P<0.05).The blood glucose and fluctuation levels,oxidation level,hs-CRP,UAER,andβ2-MG in the observation group were significantly better than control group(all P<0.05).The expression levels of serum miR-150-5p and miR-155-5p after one month were lower than those before treatment(P<0.05),and the reduction of serum miR-150-5p and miR-155-5p expression in the observation group was significantly better than that in the control group(P<0.05).CONCLUSION Treatment ofαlipoic acid-assisted olmesartan medoxomil can improve the clinical efficacy of early diabetic nephropathy and improve peripheral blood glucose levels,reduce blood glucose fluctuations,alleviate the body’s oxidation reaction,reduce inflammation,decrease serum level of miR-150-5p and miR-155-5p,and it is worthy further study and promotion.