糖尿病肾病患者血清趋化因子与氧化应激水平的相关性及α-硫辛酸的治疗作用
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淮安市科技支撑计划(HAS2010027)


The correlation of chemotactic factors and oxidative stress markers in diabetic nephropathy and the effects of α-lipoic acid
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    摘要:

    目的:观察血清趋化因子及氧化应激指标在糖尿病肾病(DN)不同时期的差异及α-硫辛酸治疗后水平的变化,探讨趋化因子与氧化应激在DN中的相关性及抗氧化应激治疗对二者的影响。方法:选择2型糖尿病患者100例,根据24 h尿白蛋白定量(24h-UAL)水平分为肾功能正常组(24h-UAL< 30 mg/24 h)-早期DN组(24h-UAL 30~300 mg/24 h)和临床DN组(24h-UAL> 300 mg/24 h),3组患者均给予α-硫辛酸治疗4周,测定各组治疗前后血清趋化因子[fractalkine(FKN)-血清单核细胞趋化蛋白-1(MCP-1)]-氧化应激指标[谷胱甘肽过氧化物酶(GSH-PX)-超氧化物歧化酶(SOD)-血清丙二醛(MDA)]-空腹血糖(FPG)-餐后2 h血糖(2hPG)-糖化血红蛋白(HbA1c)水平及24h-UAL变化。另选30例健康体检者为健康对照组。结果:①糖尿病患者GSH-PX及SOD水平显著低于健康对照组,血清趋化因子与MDA水平则显著高于健康对照组;3组治疗后血清趋化因子与MDA水平均较治疗前显著下降,GSH-PX及SOD水平则显著升高;早期DN组及临床DN组治疗后24h-UAL较治疗前显著降低;治疗前后临床DN组血清FKN-MCP-1及MDA水平均明显高于肾功能正常组和早期DN组,GSH-PX及SOD水平则显著低于另两组(P < 0.05);②趋化因子与MDA-24h-UAL-FPG-2h PG及HbA1c呈正相关,与GSH-PX和SOD呈负相关;MDA与趋化因子-24h-UAL-FPG-2hPG及HbA1c呈正相关,GSH-PX和SOD与上述指标呈负相关。结论:DN患者血清趋化因子及氧化应激指标水平与24h-UAL及血糖水平显著相关,抗氧化应激治疗能降低血清趋化因子水平,减少尿蛋白排泄,从而延缓DN的进展。

    Abstract:

    Objective:To observe the differences between serum chemotactic factors and oxidative stress markers in different periods of diabetic nephropathy(DN) and the changes of then after therapy of α-lipoic acid. To explore the correlation of chemotactic factors and oxidative stress markers in diabetic nephropathy and the effects of α-lipoic acid to them. Methods:One hundred patients with type 2 diabetic mellitus were randomly divided into normal group,early DN group and clinical DN group according to 24 hour urinary albumin(24h-UAL). Changes of FKN,MCP-1,GSH-PX,SOD,MDA,24h-UAL,FPG,2hPG,HbA1c and 24h-UAL before and after treatment of α-lipoic acid in three groups were observed. Thirty healthy person were chosen as control group. Results:①Serum GSH-PX and SOD in diabetic groups were significatly lower and serum chemotactic factors and MDA were higher than control group. Serum chemotactic factors and MDA decreased,while GSH-PX and SOD increased significantly after treatment in all groups, 24h-UAL was lower than before in early DN group and clinical DN group. Levels of FKN,MCP-1 and MDA in clinical DN group were obviously higher while GSH-PX and SOD were lower than those in normal two group and early DN group before and after treatment, (P < 0.05). ②Serum chemotactic factors were positivly correlated with MDA,24h-UAL,FPG,2hPG and HbA1c,and negativly correlatied with GSH-PX and SOD. MDA was positivly correlated with 24h-UAL,FPG,2hPG and HbA1c,while GSH-PX and SOD were opposite. Conclusion:Serum chemotactic factors and markers of oxidative stress significantly correlat with 24h-UAL and serum glucose. Serum chemotactic and urine protein are decreased by antioxidant,which may delay the progression of diabetic nephropathy.

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周 莉,陆卫平.糖尿病肾病患者血清趋化因子与氧化应激水平的相关性及α-硫辛酸的治疗作用[J].南京医科大学学报(自然科学版),2013,(10):1435-1438

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  • 收稿日期:2013-06-27
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  • 在线发布日期: 2013-10-23
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