舒洛地特对糖尿病肾病患者足细胞损伤的影响  

Effect of sulodexide on podocyte injury in patients with diabetic nephropathy

作　　者：张梦[1] 王爱凤[1] 鲁平[2] 尹明慧 马芳菲 ZHANG Meng;WANG Aifeng;LU Ping;YIN Minghui;MA Fangfei(Department of Pharmacy,Henan Provincial People′s Hospital/Fuwai Central China Cardiovascular Hospital,Zhengzhou 450003,Henan Province,China;Department of Endocrinology,Henan Provincial People′s Hospital/Fuwai Central China Cardiovascular Hospital,Zhengzhou 450003,Henan Province,China)

机构地区：[1]河南省人民医院/阜外华中心血管病医院药学部,河南郑州450003 [2]河南省人民医院/阜外华中心血管病医院内分泌科,河南郑州450003

出　　处：《新乡医学院学报》2022年第3期248-251,共4页Journal of Xinxiang Medical University

摘　　要：目的探讨舒洛地特对糖尿病肾病(DN)患者足细胞损伤的影响。方法选择2018年3月至2020年2月阜外华中心血管病医院收治的136例DN患者为研究对象,按照随机数字表法将患者分为观察组和对照组,每组68例。2组患者均给予皮下注射胰岛素或口服降糖药降低血糖、血管紧张素转换酶抑制剂和血管紧张素Ⅱ受体拮抗剂降血压、他汀类药物降血脂等常规治疗措施,观察组患者在常规治疗基础上给予舒洛地特治疗,2组患者均连续治疗4个月。对2组患者治疗前后24 h尿蛋白定量及血清肌酐(Scr)、血尿素氮(BUN)、血管生成素样蛋白4(ANGPTL4)和尿沉渣中podocin、mindin及nephrin蛋白水平进行比较,并观察治疗期间2组患者的不良反应。结果2组患者治疗前24 h尿蛋白定量及Scr、BUN水平比较差异无统计学意义(P>0.05),2组患者治疗后24 h尿蛋白定量及Scr、BUN水平显著低于治疗前(P<0.05);治疗后,观察组患者24 h尿蛋白定量及Scr、BUN水平显著低于对照组(P<0.05)。治疗前2组患者尿沉渣中podocin、mindin、nephrin蛋白水平比较差异无统计学意义(P>0.05),2组患者治疗后尿沉渣中podocin、mindin、nephrin蛋白水平显著低于治疗前(P<0.05);治疗后,观察组患者尿沉渣中podocin、mindin、nephrin蛋白水平显著低于对照组(P<0.05)。2组患者治疗前血清ANGPTL4水平比较差异无统计学意义(P>0.05),2组患者治疗后血清ANGPTL4水平显著高于治疗前(P<0.05);治疗后,观察组患者血清ANGPTL4水平显著高于对照组(P<0.05)。治疗期间,对照组和观察组患者不良反应发生率分别为8.82%(6/68)、11.76%(8/68),2组患者治疗期间不良反应发生率比较差异无统计学意义(χ^(2)=0.319,P>0.05)。结论舒洛地特可有效减轻DN患者肾小球足细胞损伤,改善肾功能。Objective To investigate the effect of sulodexide on podocyte injury in patients with diabetic nephropathy(DN).Methods A total of 136 DN patients admitted to Fuwai Central China Cardiovascular Hospital from March 2018 to February 2020 were selected as the research subjects,and the patients were divided into the observation group and the control group according to the random number table method,with 68 cases in each group.The patients in both groups were given subcutaneous insulin injection or oral hypoglycemic drugs to lower blood sugar,angiotensin-converting enzyme inhibitors and angiotensinⅡreceptor antagonists to lower blood pressure,statins to lower blood lipids and other conventional treatments.The patients in the observation group were given sulodexide on the basis of conventional treatment.The patients in both groups were treated for 4 months.The 24-hour urine protein quantification,serum creatinine(Scr),blood urea nitrogen(BUN),angiopoietin-like protein 4(ANGPTL4)and the podocin,mindin,nephrin protein levels in urinary sediment were compared between the two groups before and after treatment.The adverse reactions of the patients in the two groups during the treatment period were observed.Results There was no significant difference in the 24-hour urine protein quantification,Scr and BUN levels between the two groups before treatment(P>0.05).The 24-hour urine protein quantification,Scr and BUN levels in the two groups after treatment were significantly lower than those before treatment(P<0.05).The 24-hour urine protein quantification,Scr and BUN levels in the observation group were significantly lower than those in the control group after treatment(P<0.05).There was no significant difference in the levels of podocin,mindin and nephrin protein in urinary sediment between the two groups before treatment(P>0.05).The levels of podocin,mindin and nephrin protein in urinary sediment after treatment were s ignificantly lower than those before treatment in the two groups(P<0.05).The levels of podocin,mindin and ne

关 键 词：糖尿病肾病 舒洛地特 足细胞 血管生成素样蛋白4 

分 类 号：R587.2[医药卫生—内分泌]