α-硫辛酸联合氯沙坦治疗早期糖尿病肾病的临床观察  

Renoprotective effect of α-thioctic acid combined with losartan on early diabetic nephropathy

作　　者：云鹏[1] 肖虎[2] 龚婷[2] 陈皓[2] 柳丹[2] 

机构地区：[1]长江大学临床医学院内科教研室,湖北荆州434000 [2]长江大学附属第一医院内分泌科,湖北荆州434000

出　　处：《中国医院药学杂志》2012年第13期1035-1038,共4页Chinese Journal of Hospital Pharmacy

基　　金：湖北省荆州市科技局基金(编号:2010ZD-16)

摘　　要：目的:观察α-硫辛酸联合氯沙坦治疗早期糖尿病肾病(DN)的疗效并探讨其协同作用机制。方法:116例早期DN患者随机分为3组,在一般治疗基础上,A组39例予氯沙坦钾片治疗(50 mg,qd);B组39例予α-硫辛酸胶囊治疗(300 mg,bid);C组38例予氯沙坦钾片(50 mg,qd)+α-硫辛酸胶囊(300 mg,bid)治疗,时间均为3个月。比较3组治疗前后的24 h尿白蛋白排泄率(UAER)、血糖、糖化血红蛋白、血压、血脂、肾功能、尿转化生长因子-β1(TGF-β1)、血清超氧化物歧化酶(SOD)及谷胱甘肽过氧化物酶(GSH-Px)活性。结果:3组治疗后UAER、尿TGF-β1均较前明显下降,其中C组显著低于A组和B组(P<0.05或<0.01);治疗后B组、C组血清SOD、GSH-Px活性明显高于A组(P<0.01)。结论:α-硫辛酸联合氯沙坦可更有效治疗早期DN,其协同作用机制可能是通过更有效改善氧化应激进而下调肾脏TGF-β1的高表达。OBJECTIVE To observe the effect of combined α-thioctic acid and losartan on patients with early diabetic ne- phropathy（DN）. METHODS 116 early DN patients were randomly divided into 3 groups：group A were given losartan（n = 39, 50 mg·d^-1 ）,group B were orally given α-thioctic acid（n = 39,600 mg·d^-1 ）, group C were given combined α-thioctic acid and losartan（n = 38,600 mg·d^-1 ＋ 50 mg·d^-1 ）. Time of therapy was 3 months and all cases were given the same elementary treat- ment. The change of urinary albumin excretion rate （UAER）, urinary transforming growth factor-β1 （TGF-β1）, serum superox- ide dismutases（SOD） and glutathione peroxidase（GSH-Px） were investigated. RESULTS After treatment,UAER and TGF-β1 of all groups were significantly decreased（P〈0.05 or 〈0. 01）;UAER and TGF-β1 of group C were significant lower than group A and group B, meanwhile the serum SOD and GSH-Px were higher than the other two groups（P〈0. 01 ）. CONCLUSION α-thioctic acid combined with losartan can more effectively heal early DN. The synergistic effect may be related to the better depression of oxidative stress and consequently decreased the level of TGF-β1.

关 键 词：糖尿病肾病 Α-硫辛酸 氯沙坦 氧化应激 

分 类 号：R969[医药卫生—药理学]