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目的:探讨氯沙坦对早期糖尿病肾病(DN)患者转化生长因子TGF-β1、结缔组织生长因子(CTGF)水平的影响。方法:70例早期DN患者随机分组,对照组(35例)采用糖尿病(DM)常规治疗,治疗组(35例)在常规治疗基础上加用氯沙坦,疗程2个月。采用酶联免疫吸附法(ELISA)测定两组患者治疗前后尿TGF-β1、CTGF水平,同时观察血压、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、空腹血糖、及餐后2h血糖、BUN、血肌酐(Scr)、24h尿白蛋白(UALB)等指标的变化。结果:与治疗前比较,患者治疗后尿TGF-β1和CTGF水平下降(P<0.05),UALB降低,血压、空腹血糖、餐后2h血糖、Scr、BUN指标改善(P<0.05),对照组治疗后尿TGF-β1升高(P<0.05),CTGF变化不大;后上述指标改善不如观察组。结论:氯沙坦可通过降低DN患者TGF-β1、CTGF水平而延缓DN的发展。
Objective: To investigate the effect of losartan on the levels of transforming growth factor (TGF-β1) and connective tissue growth factor (CTGF) in patients with early diabetic nephropathy (DN). Methods: Seventy patients with early DN were randomly divided into control group (n = 35) and conventional therapy (n = 35). Losartan was given to the treatment group (n = 35) on the basis of routine treatment for two months. Urinary TGF-β1 and CTGF levels in both groups before and after treatment were measured by enzyme-linked immunosorbent assay (ELISA). Blood pressure, cholesterol (TC), triglyceride (TG), high density lipoprotein (LDL), fasting blood glucose, postprandial blood glucose 2h, BUN, serum creatinine (Scr), 24h urinary albumin (UALB) and other indicators. Results: Compared with before treatment, the levels of urinary TGF-β1 and CTGF decreased (P <0.05), UALB decreased, blood pressure, fasting blood glucose, postprandial blood glucose 2h, Scr and BUN improved (P < After treatment, urinary TGF-β1 increased (P <0.05), CTGF changed little; after the improvement of these indicators than the observation group. Conclusion: Losartan can delay the development of DN by decreasing the levels of TGF-β1 and CTGF in DN patients.