辛伐他汀联合α-硫辛酸及福辛普利对糖尿病肾病的疗效及对MDA和FMDSOD水平的影响

Effect of simvastatin combined withα-lipoic acid and fosinopril on diabetic nephropathy and influence on MDA,FMDSOD and their levels

目的探讨辛伐他汀联合α-硫辛酸、福辛普利对糖尿病肾病患者肾功能及糖脂代谢水平的影响。方法选取2021年4月至2023年4月郑州人民医院收治糖尿病肾病88例患者,采用随机数字表法分为两组,对照组44例采用α-硫辛酸、福辛普利治疗,观察组44例采用辛伐他汀联合α-硫辛酸及福辛普利治疗,均在治疗后3个月后比较疗效及氧化应激指标丙二醛(malondialdehyde,MDA)及超氧化物歧化酶(superoxide dismutase,SOD)等水平的变化情况。结果两组治疗前糖化血红蛋白(HbA1c)、空腹血糖(fasting blood glucose,FPG)、餐后2 h血糖(2 h postprandial blood glucose,2 h PG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)水平比较差异无统计学意义(P>0.05),治疗后均降低,与治疗前比较有统计学意义(P<0.05),且观察组治疗后LDL-C及TG水平分别是(3.11±0.44)mmol/L和(1.09±0.21)mmol/L,均低于对照组(P<0.05),两组治疗后HbA1c、FPG、2 h PG及TC水平比较差异无统计学意义(P>0.05);两组治疗前肾功能比较差异无统计学意义(P>0.05),治疗8周后均降低,与治疗前比较有统计学意义(P<0.05),且观察组治疗后8周的24 h尿蛋白、血肌酐(Scr)及尿素氮(BUN)水平分别是(1.15±0.11)g/L、(177.48±8.54)μmol/L和(7.46±1.08)mmol/L,均低于对照组(P<0.05);两组治疗前氧化应激指标比较差异无统计学意义(P>0.05),治疗8周后观察组FMD及SOD水平分别为(14.48±2.23)%和(98.96±9.86)U/mL,高于对照组(P<0.05),观察组治疗8周后MDA水平(4.37±1.24)μmol/L,低于对照组(P<0.05)。结论糖尿病肾病患者进行α-硫辛酸联合福辛普利治疗,可改善肾功能,有效降低氧化应激水平。

Objective Discuss the effects ofα-lipoic acid combined with fosinopril on renal function and glucose and lipid metabolism in diabetic nephropathy patients.Methods A total of 88 patients with diabetic nephropathy admitted to Zhengzhou People's Hospital from April 2021 to April 2023 were divided into two groups by random number table method.44 patients in the control group were treated withα-lipoic acid and fosinopril,and 44 patients in the observation group were treated with simvastatin combined withα-lipoic acid and fosinopril.The therapeutic effect and the changes of oxidative stress indexes such as malondialdehyde(MDA)and superoxide dismutase(SOD)were compared 3 months after treatment.Results There was no significant difference in the levels of HbA1c,fasting blood glucose(FPG),2 h postmeal blood glucose(2hPG),low-density lipoprotein cholesterol(LDL-C),triglyceride(TG)and total cholesterol(TC)between the two groups before treatment(P>0.05),but all decreased after treatment.Compared with before treatment,LDL-C and TG levels in the observation group were(3.11±0.44)mmol/L and(1.09±0.21)mmol/L,respectively,which were lower than those in the control group(P<0.05).There was no significant difference in the levels of HbA1c,FPG,2hPG and TC between the two groups after treatment(P>0.05).There was no statistical significance in renal function between the two groups before treatment(P>0.05),and the renal function decreased after 8 weeks of treatment,which was statistically significant compared with that before treatment(P<0.05).The levels of 24h urinary protein,serum creatinine(Scr)and urea nitrogen(BUN)in the observation group were(1.15±0.11)g/L,(177.48±8.54)μmol/L and(7.46±1.08)mmol/L,respectively,at 8 weeks after treatment,all lower than those in the control group(P<0.05).There was no significant difference in oxidative stress indexes between the two groups before treatment(P>0.05).After 8 weeks of treatment,FMD and SOD levels in the observation group were(14.48±2.23)%and(98.96±9.86)U/mL,respectively,which were higher than those in the control group(P<0.05).After 8 weeks of treatment,the MDA level in the observation group was(4.37±1.24)μmol/L,which was lower than that in the control group(P<0.05).Conclusionα-lipoic acid combined with fosinopril can improve renal function and effectively reduce the level of oxidative stress in diabetic nephropathy patients.