α硫辛酸用于早期糖尿病肾病的临床效果观察  

Clinical effect of alpha lipoic acid on early diabetic nephropathy

作　　者：姜文娟[1] 周连华[1] 张进安[1] 

机构地区：[1]复旦大学附属金山医院内分泌科,上海201508

出　　处：《中国综合临床》2013年第10期1040-1042,共3页Clinical Medicine of China

摘　　要：目的观察α硫辛酸应用于早期糖尿病肾病（DN）的临床疗效。方法70例早期DN患者随机分为使用仅硫辛酸组35例（观察组）和未使用0【硫辛酸治疗组35例（对照组）。对照组予以常规的控制血糖等治疗；治疗组加用d硫辛酸300mg／d静脉滴注，治疗两周，观察两组治疗前、后的超敏C反应蛋白（hs—CRP）、尿微量白蛋白及肌酐变化，并在3个月后复查尿微量白蛋白与尿肌酐。结果经过两周的治疗，治疗组的hs—CRP从（3．92±4．56）mg／L下降至（2．24±2．49）mg／L，差异有统计学意义（t=2．803，P〈0．05），尿微量白蛋白从（127．18±76．91）mg／L下降至（84．50±122．87）mg／L，差异有统计学意义（t=2．501，P〈0．05），尿微量白蛋白与尿肌酐的比值从（28．95±30．49）mg／mmol下降至（13．76±20．83）mg／mmol，差异有统计学意义（t=3．616，P〈0．05）。而对照组差异则无统计学意义。但3个月后两组的尿微量白蛋白及其与尿肌酐的比值与治疗前相比差异均无统计学意义（P均〉0．05）。结论仪硫辛酸治疗后短期内能够减少DN患者的尿微量白蛋白，但其能否长期减少DN患者的尿微量白蛋白有待进一步研究。Objective To investigate the clinical application of alpha lipoic acid on early diabetic nephropathy（DN）. Methods Seventy patients with early diabetic nephropathy were randomly divided into two groups. Patients in control group were treated with regular glycemic control methods, while patients in treatment group were received alpha lipoic acid 300 mg static drop treatment for two weeks beside regular treatment. High sensitivity C reaction protein, microalbuminuria and urine creatinine were measured before and after the treatment. Microalbuminuria and urine creatinine were re-measured three months later. Results At the end of two weeks treatment, the levels of high sensitivity C reaction protein in the treatment group decreased from （3.92± 4. 56） mg/L to （ 2. 24 ± 2.49 ） mg/L, and there was significant difference （ t = 2. 803, P 〈 0. 05 ）. Microalbuminuria decreased from （ 127. 18± 76. 91 ） mg/L to （ 84. 50 ± 122. 87 ） mg/L, and there was significant difference（ t = 2. 501, P 〈 0. 05 ） . The ratio of microalbuminuria and urine creatinine in treatment group decreased from （28.95± 30.49 ） mg/mmol to （ 13.76± 20.83 ） mg/mmol, and there was significant difference （t =3. 616 ,P 〈 0. 05）. While there was no significant difference in the control group before and after regular waglycemic control. At three months after treatment, there were no significant difference regarding of microalbuminuria, the ratio of microalbuminuria and urine creatinine between treatment and control groups （ P 〉 0. 05 ）. Conclusion Alpha lipoic acid might be with ability of decreasing the levels of microalbuminuria of diabetic nephropathy in the short term, but further study is needed to verify whether alpha lipoic acid can decrease the level of microalbuminuria in the long term.

关 键 词：硫辛酸 糖尿病肾病 尿微量白蛋白 

分 类 号：R587.2[医药卫生—内分泌]