PSS注射液对早期糖尿病肾病t-PA/PAI-1异常的影响及疗效观察

Effects of polysaccharide sulfate on blood viscosity,urine protein excretion and serum t-PA/PAI-1 activity in patients with early diabetic nephropathy

目的 探讨PSS注射液防治早期糖尿病肾病的疗效及其机制。方法 178例早期糖尿病肾病患者被随机分为对照组72例 ,以格列喹酮 (糖适平 ) 30mg·次 -1,po ,tid ;治疗组 10 6例 ,在此治疗的基础上 ,PSS注射液 10 0mg加入 0 .9%氯化钠静滴 ,每日 1次 ,连续观察 14d。结果 治疗组血浆的t PA/PAI 1的活性 ,全血黏度 ,血浆黏度 ,纤维蛋白原 ,血清TG ,TCH ,APOB10 0 ,LDL C ,2 4h尿蛋白定量 ,尿白蛋白排出率和肾功能都有显著性的改善 (P <0 .0 0 1) ;与对照组比较有显著性差异 (P<0 .0 5或P <0 .0 0 1)。对照组只有高切全血黏度和三酰甘油有显著性的改善 (P <0 .0 5 )。结论 PSS注射液可通过调节t PA/PAI 1的活性、降低血脂、血黏度 ,改善肾脏微循环 ,减少尿蛋白的排出 ;适用于防治糖尿病的早期肾损害。

OBJECTIVE: To investigate the effects of polysaccharide sulfate(PSS) injection on t-PA/PAI-1, blood viscosity and urine protein excretion in the patients with early diabetic nephropathy. METHODS: 178 cases of early diabetic nephropathy undergoing gliquidone therapy were divided randomly into control and treatment groups. 100 mg PSS injection was given by iv. drip, qd, in 106 cases of treatment group while control group took glidagide alone. The experiment lasted for 14 days. Before and after treatment, serum t-PA/PAI-1 activity, lipid profile, blood viscosity, 24 hours urine protein quantity(24 h UPQ), urine albumin excretion rate(UAER), Scr and effective renal plasma flow were determined. RESULTS: After 14 days the changes of indexes were as follows: In the control group, only high shearing rate viscosity of blood TG was improved significantly (P < 0.05). Total effective rate was 64.3%. In the treatment group, TG, TCH, APOB100, LDL-C, blood viscosity, 24 hours urine protein quantity (24 h UPQ), urine albumin excretion rate(UAER), Scr and effective renal plasma flow improved significantly (P < 0.05 or P < 0.001). Total effective rate was 92.1%. There were significant differences between control and therapy groups (P < 0.05 & 0.001). CONCLUSIONS: PSS injection may reduce lipid, modulate t-PA/PAI-1 activity, improve hemorrheology in renal microcirculation, and decrease urine protein excretion rate respectively. PSS may have better therapeutic efficacy for the patients with early diabetic nephropathy.