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目的观察α-硫辛酸在早期糖尿病肾病患者治疗中的临床疗效及对尿微量白蛋白排泄率和血浆内皮素- 1水平的影响。方法 80例早期糖尿病肾病患者随机分为对照组和试验组,各40例。对照组用常规方法治疗,试验组每天静脉滴注α-硫辛酸450 m L,2组均连续治疗2周。比较2组患者的临床疗效,观察2组患者治疗前后空腹血糖、餐后2 h血糖、收缩压、舒张压、血清超氧化物歧化酶(SOD)和丙二醛(MDA)含量。结果治疗后,试验组空腹血糖为(5.72±1.23)mmol·L~(-1),餐后2 h血糖为(9.55±1.58)mmol·L~(-1),收缩压为(117.09±5.77)mm Hg,舒张压为(84.10±5.69)mm Hg,显著低于对照组的(6.42±1.29)mmol·L~(-1),(10.59±1.66)mmol·L~(-1),(125.97±7.82)mm Hg,(90.98±5.61)mm Hg(P<0.05)。治疗后,试验组血清超氧化物歧化酶为(94.68±6.31)U·mg~(-1),显著高于对照组的(64.38±4.54)U·mg~(-1)(P<0.05);试验组丙二醛为(2.63±0.49)mmol·L~(-1),显著低于对照组的(3.98±0.16)mmol·L~(-1)(P<0.05)。治疗后,试验组尿微量白蛋白排泄率为(32.15±5.17)μg·min~(-1),血浆内皮素- 1为(20.43±2.11)ng·L~(-1),显著低于对照组的(77.95±10.79)μg·min~(-1),(59.15±6.44)ng·L~(-1)(P<0.05)。2组均无明显药物不良反应发生。结论α-硫辛酸治疗早期糖尿病肾病患者效果理想,能显著降低尿微量白蛋白排泄率和血浆内皮素-1水平。
Objective To investigate the clinical efficacy of α-lipoic acid in the treatment of patients with early diabetic nephropathy and its effect on urinary albumin excretion and plasma endothelin-1 levels. Methods 80 patients with early diabetic nephropathy were randomly divided into control group and experimental group, 40 cases in each. The control group was treated by conventional method. The test group was given a daily intravenous infusion of α-lipoic acid 450 m L, and the two groups were treated continuously for 2 weeks. The clinical effects of two groups were compared. The fasting blood glucose, postprandial blood glucose, systolic blood pressure, diastolic blood pressure, serum superoxide dismutase (SOD) and malondialdehyde (MDA) were measured before and after treatment. Results After treatment, the fasting blood glucose of the experimental group was (5.72 ± 1.23) mmol·L -1, the postprandial blood glucose was (9.55 ± 1.58) mmol·L -1 and the systolic pressure was 117.09 ± 5.77 ) mm Hg, diastolic pressure was (84.10 ± 5.69) mm Hg, which was significantly lower than that of the control group (6.42 ± 1.29 mmol·L -1, 10.59 ± 1.66 mmol·L -1, 125.97 ± 7.82) mm Hg, (90.98 ± 5.61) mm Hg (P <0.05). After treatment, the level of serum superoxide dismutase in the test group was (94.68 ± 6.31) U · mg -1, which was significantly higher than that of the control group (64.38 ± 4.54 U · mg -1) (P <0.05) (2.63 ± 0.49) mmol·L -1, which was significantly lower than that of the control group (3.98 ± 0.16) mmol·L -1 (P <0.05). After treatment, the urinary albumin excretion rate of the experimental group was (32.15 ± 5.17) μg · min -1 and the level of plasma ET-1 was (20.43 ± 2.11) ng · L -1, which was significantly lower than that of the control (77.95 ± 10.79) μg · min ~ (-1), (59.15 ± 6.44) ng · L ~ (-1), P <0.05). No obvious adverse drug reactions occurred in both groups. Conclusion α-lipoic acid treatment of early diabetic nephropathy patients with satisfactory results, can significantly reduce the urinary albumin excretion rate and plasma endothelin-1 levels.