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目的探讨厄贝沙坦对早期糖尿病肾病肿瘤坏死因子-α(TNF-α)的影响。方法将早期糖尿病肾病患者46例分为A组、B组;两组均予常规降糖治疗,A组在常规治疗基础上加用药物厄贝沙坦治疗,疗程12周,同时设健康对照组。观察A、B两组治疗前后血清TNF-α、糖化血红蛋白、空腹血糖、谷丙转氨酶、尿素氮、肌酐、肾脏彩色多普勒血流情况、HOMA2-IR;同时记录治疗过程中尿白蛋白排出量(UAE)和平均动脉压(MAP)情况。观测健康参照组以上参数(检查只做一次)。结果早期糖尿病肾病患者TNF-α水平均高于健康参照组(P<0.01),厄贝沙坦治疗A组后TNF-α水平比B组低(P<0.05)。结论降低血清TNF-α水平可能是厄贝沙坦治疗早期糖尿病肾病机制之一。
Objective To investigate the effect of irbesartan on tumor necrosis factor-α (TNF-α) in early diabetic nephropathy. Methods 46 patients with early diabetic nephropathy were divided into group A and group B. The two groups were given conventional hypoglycemic treatment. Group A was treated with irbesartan on the basis of conventional treatment for 12 weeks. At the same time, a healthy control group . The levels of serum TNF-α, HbAlc, fasting blood glucose, alanine aminotransferase, urea nitrogen, creatinine and renal color Doppler blood flow and HOMA2-IR in group A and group B before and after treatment were recorded. Urinary albumin excretion (UAE) and mean arterial pressure (MAP). Observed health reference group above parameters (check only once). Results The levels of TNF-α in patients with early diabetic nephropathy were significantly higher than those in healthy controls (P <0.01). The levels of TNF-α in irbesartan-treated patients were lower than those in patients in group B (P <0.05). Conclusion Lowering serum TNF-αlevel may be one of the mechanisms of irbesartan in the treatment of early diabetic nephropathy.