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目的 :检测糖尿病肾病 (DN)患者治疗前后血管紧张素Ⅱ (AT -Ⅱ )、血管内皮生长因子(VEGF)、内皮素 (ET)和心钠素 (ANP)含量变化 ,以比较不同药物的治疗效果。方法 :对象为DN患者分为 2组 :中药治疗观察组 35例 ;对照组 35例 ;正常对照组 35例。用放免法和ELISA法分别测定治疗前后血浆AT -Ⅱ、VEGF、ET和ANP水平。结果 :2组DN患者治疗前AT -Ⅱ、VEGF、ET和ANP含量均明显高于正常对照组 (p <0 0 5～ 0 0 1) ,治疗后较治疗前明显降低 (p<0 0 5～ 0 0 1)。观察组治疗后各含量下降较对照组明显。糖尿病肾病患者AT -Ⅱ含量与VEGF呈正相关 (r=0 4 6 5 ,p<0 0 5 ) ,血浆ET含量与ANP呈正相关 (r=0 6 1,p <0 0 5 ) ,观察组疗效稍好于对照组。结论 :AT -Ⅱ、VEGF、ET和ANP与DN的发生发展和病情的严重程度有关 ,它们之间可相互作用共同参与DN病变过程。以它们的指标作为疗效观察 ,中西药结合治疗糖尿病肾病患者效果较好。
Objective: To detect the changes of the content of angiotensin Ⅱ (AT-Ⅱ), vascular endothelial growth factor (VEGF), endothelin (ET) and atrial natriuretic peptide (ANP) in diabetic nephropathy patients before and after treatment, effect. Methods: The subjects with DN were divided into two groups: 35 cases in the observation group of traditional Chinese medicine treatment group, 35 cases in the control group and 35 cases in the normal control group. The levels of AT-II, VEGF, ET and ANP in plasma before and after treatment were determined by radioimmunoassay and ELISA respectively. Results: The levels of AT-II, VEGF, ET and ANP before treatment in two DN groups were significantly higher than those in normal control group (p <0.05-0.01), and were significantly lower than those before treatment (p <0.05 ~ 0 0 1). Observed group decreased after treatment than the control group. There was a positive correlation between the content of AT-II and the level of VEGF in patients with diabetic nephropathy (r = 0 465, p 0 05), and the plasma level of ET was positively correlated with ANP (r 0 01, p 0 05) Slightly better than the control group. CONCLUSION: AT-II, VEGF, ET and ANP are related to the occurrence and development of DN and the severity of the disease. They can interact with each other and participate in the pathogenesis of DN. With their indicators as the efficacy of observation, the combination of Chinese and Western medicine treatment of diabetic nephropathy better.