甲钴胺联合α-硫辛酸治疗糖尿病神经病变的疗效及对血清氧化应激水平的影响  

Efficacy of mecobalamin combined with α-lipoic acid on diabetic neuropathy and serum oxidative stress level

作　　者：孙华 顾芹 聂晶[1] 孙文丽[1] 熊静芳[1] SUN Hua;GU Qin;NIE Jing;SUN Wenli;XIONG Jingfang(Department of Geriatrics,Hangzhou Red Cross Hospital,Hangzhou 310003,China;Department of Endocrinology,Huadong Hospital Affiliated to Fudan University,Shanghai 200040,China)

机构地区：[1]浙江省杭州市红十字会医院老年科,杭州310003 [2]复旦大学附属华东医院内分泌科,上海200040

出　　处：《中国临床药学杂志》2021年第5期325-329,共5页Chinese Journal of Clinical Pharmacy

摘　　要：目的观察甲钴胺联合α-硫辛酸治疗对糖尿病神经病变(DN)患者神经症状的改变及对血清氧化应激水平的影响。方法选取DN患者58例,随机分为观察组33例和对照组25例。对照组予甲钴胺(1 mg·d^(-1), iv)治疗,观察组予甲钴胺联合α-硫辛酸(甲钴胺1 mg·d^(-1)+α-硫辛酸600 mg·d^(-1),iv)治疗,疗程均为10d。记录2组患者治疗前后的DN症状学评分,并检测治疗前后血清半胱氨酸蛋白酶抑制剂C(CysC)、8-羟基脱氧鸟苷(8-OHd G)、白介素-6(IL-6)、同型半胱氨酸(Hcy)和可溶性细胞黏附分子-1(s ICAM-1)水平。结果治疗后,观察组DN症状学评分不仅低于同组治疗前(P <0.05),也低于对照组(P <0.05);而对照组DN症状学评分虽较同组治疗前有所降低,但差异未见统计学意义(P> 0.05)。治疗前后,2组CysC、8-OHd G、IL-6、Hcy和s ICAM-1水平经比较,组间差异均无统计学意义(P> 0.05)。与治疗前相比,观察组治疗后血清CysC水平显著降低(P <0.05),余指标差异均无统计学意义(P> 0.05)。结论与单药甲钴胺相比,甲钴胺联合α-硫辛酸治疗可降低DN患者DN症状学评分,提示对患者的临床神经症状有改善作用;同时可降低血清CysC水平,提示血清CysC对DN患者的临床预后可能有预测价值。AIM To observe the effect of mecobalamin combined with α-lipoic acid on the changes of neurological symptoms and serum oxidative stress level in patients with diabetic neuropathy(DN). METHODS A total of 58 patients with DN were randomly divided into observation group(n=33) and control group(n=25). The patients in control group were treated with mecobalamin(1 mg·d^(-1), iv), while the patients in observation group were treated with mecobalamin(1 mg·d^(-1), iv) combined with α-lipoic acid(600 mg·d^(-1), iv). All patients were treated for 10 d. The DN symptom scores of 2 groups before and after treatment were recorded, and the serum cystatin C(CysC), 8-hydroxy-2’-deoxyguanosine(8-OHdG), interleukin-6(IL-6), homocysteine(Hcy) and soluble intercellular adhesion molecule-1(sICAM-1) levels were detected before and after treatment. RESULTS After treatment, the DN symptom scores in the observation group were not only lower than those before treatment(P < 0.05), but also lower than those in the control group(P < 0.05);the DN symptom scores in the control group were lower than those before treatment, but the difference was not statistically significant(P > 0.05). Before and after treatment, there was no significant difference in the levels of CysC, 8-OHdG, IL-6, Hcy and sICAM-1 between 2 groups(P > 0.05). Compared with before treatment, the level of serum CysC in the observation group was decreased significantly after treatment(P < 0.05), and there was no significant difference in other indexes(P > 0.05). CONCLUSION Compared with mecobalamin monotherapy, mecobalamin combined α-lipoic acid treatment can reduce the DN symptom scores of patients with DN, suggesting that it can improve the clinical neurological symptoms of patients;it can reduce the level of serum CysC at the same time, suggesting that serum CysC may have predictive value for the clinical prognosis of patients with DN.

关 键 词：Α-硫辛酸 甲钴胺 糖尿病神经病变 氧化应激 

分 类 号：R587.2[医药卫生—内分泌]