缬沙坦对早期糖尿病肾病患者血清CysC水平的影响  

Effects of Valsartan on Serum CysC Levels in Patients with Early Diabetic Nephropathy

作　　者：冯然[1] 刘静芹[1] 崔博坤 于洋 FENG Ran;LIU Jingqin;CUI Bokun;YU Yang(Department of Endocrinology,the First Hospital of Baoding,Baoding,Hebei Province,071000 China)

机构地区：[1]保定市第一医院内分泌科,河北保定071000

出　　处：《系统医学》2022年第13期99-102,共4页Systems Medicine

基　　金：河北省医学科学研究重点课题计划(20191230)。

摘　　要：目的探讨缬沙坦对早期糖尿病肾病(diabetic nephropathy,DN)患者血清胱抑素C(cystatin C,CysC)水平的影响。方法选择2017年1月—2020年6月在保定市第一医院内分泌科住院的2型糖尿病(type 2 diabetes mellitus,T2DM)患者66例,分为正常白蛋白尿1组(NA1组,UMA/Cr<10μg/mg)12例,正常白蛋白尿2组(NA2组,UMA/Cr 10~30μg/mg)19例,微量白蛋白尿组(MA组,UMA/Cr 31~300μg/mg)35例,均合并DR、高血压,应用缬沙坦80 mg/d共4周。30名体检健康者作为对照组(NC组)。治疗前后测定血清CysC水平。结果NA1组、NA2组、MA组血清CysC水平(1.05±0.34)mg/L、(1.27±0.18)mg/L、(1.83±0.31)mg/L较NC组(0.54±0.23)mg/L明显升高,差异有统计学意义(F=125.728,P<0.001)。用药后,血清CysC水平较用药前明显下降[NA1组(1.05±0.34)mg/L vs(0.82±0.33)mg/L、NA2组(1.27±0.18)mg/L vs(1.06±0.24)mg/L、MA组(1.83±0.31)mg/L vs(1.58±0.25)mg/L],差异有统计学意义(t=5.411、4.995、6.776,P<0.001)。Pearson相关分析结果显示CysC与DN呈正相关(r=0.711,P<0.001)。结论血清CysC可反映早期肾损伤的指标,对早期DN的诊断有重要意义,缬沙坦的早期应用可降低血清CysC水平。Objective To investigate the effect of valsartan on serum cystatin-C(CysC)level in patients with early diabetic nephropathy(DN).Methods A total of 66 patients with T2 DM who were hospitalized in the Endocrinology Department of Baoding First Hospital from January 2017 to June 2020 were selected,and divided into normoalbuminuria group 1(NA1 group,UMA/Cr<10μg/mg)12 cases,normoalbuminuria group 2(NA2 group,UMA/Cr 10-30μg/mg)19 cases,microalbuminuria group(MA group,UMA/Cr 31-300μg/mg)35 cases.All patients were complicated with DR and hypertension,and were treated with valsartan 80 mg/d for 4 weeks.Thirty healthy subjects were selected as the control group(NC group).Serum CysC levels were measured before and after treatment.Results Serum CysC levels in NA1,NA2 and MA groups(1.05±0.34)mg/L,(1.27±0.18)mg/L,(1.83±0.31)mg/L were significantly higher than those in NC group(0.54±0.23)mg/L,the difference was statistically significant(F=125.728,P<0.001).After treatment,the serum CysC level was significantly lower than before treatment[NA1 group(1.05±0.34)mg/L vs(0.82±0.33)mg/L,NA2 group(1.27±0.18)mg/L vs(1.06±0.24)mg/L,MA groups(1.83±0.31)mg/L vs(1.58±0.25)mg/L],the difference was statistically significant(t=5.411,4.995,6.776,P<0.001).The results of Pearson correlation analysis showed that CysC was positively correlated with DN(r=0.711,P<0.001).Conclusion Serum CysC may be an indicator of early kidney injury,which is of great significance for the diagnosis of early DN;early application of valsartan can reduce the level of serum CysC.

关 键 词：糖尿病肾病 胱抑素-C 缬沙坦 

分 类 号：R4[医药卫生—临床医学]