黄芪注射液对糖尿病肾病患者血Ⅳ型胶原与转化生长因子-β_1水平的影响及其意义

Influence of astragalus injection on serum type IV collagen and transforming growth factor-β_1 in diabetic nephropathy patients

目的 探讨黄芪注射液对糖尿病肾病 (DN)的治疗作用及机理。方法 90例 2型糖尿病患者根据微量白蛋白排泄率分为正常蛋白尿组 (A组 )、微量白蛋白尿组 (B组 )、临床蛋白尿组 (C组 ) ,分别检测其血糖、糖化血红蛋白、血尿素氮、肌酐、Ⅳ型胶原、转化生长因子 β1 。A、B、C 3组又随机分为黄芪注射液治疗组和常规治疗组。结果 糖尿病各组HbA1c、尿微量白蛋白 (UAER)、血清Ⅳ型胶原、TGF β1 水平均显著增高。相关分析表明血清Ⅳ型胶原、TGF β1 、HbA1c与Cr、UAER呈正相关 ,HbA1c、TGF β1 与血清Ⅳ型胶原呈正相关。黄芪注射液治疗组治疗后HbA1c、UAER、血清Ⅳ型胶原、TGF β1 均显著降低。结论 糖尿病患者存在胶原代谢异常 ,且与TGF β1 、非酶糖化有关。黄芪注射液能减少TGF β1 的产生、降低非酶糖化 ,抑制肾脏纤维化。

Objective To explore the effect of astragalus injection on diabetic nephropathy and its mechanism.Methods 90 cases of type 2 diabetes were divided into normoalbuminuria group(group A),microalbuminuria group(group B) and clinical albuminuria group(group C) according to urine albumin excretion rate(UAER),which were subdivided into astragalus treatment group and routine treatment group.Blood glucose,glycosylated hemoglobin,blood urea nitrogen,creatinine(Cr),type IV collagen(C IV),transforming growth factor β 1 (TGF β 1) were detected in all cases.Results Glycosylated hemoglobin,UAER,C IV,and TGF β 1 were significantly increased in aall groups.The correlation analysis showed that C IV,TGF β 1,and glycosylated hemoglobin were positively correlated with Cr and UAER.HbA1c and TGF β 1 were positively correlated with C IV.Glycosylated hemoglobin,UAER,C IV and TGF β 1 were significantly decreased after astragalus injection treatment.Conclusion The presence of abnormal collagen metabolism in diabetic nephropathy patients is related to increased TGF β 1 and non enzymatic glycosylation.Astragalus injection can protect diabetic mellitus kidney and prevent fibrosis of kidney by inhibiting the production of TGF β 1 and non enzymatic glycosylation.