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目的观察罗格列酮对早期糖尿病肾病(DN)患者炎症因子和内皮功能的影响。方法将50例糖尿病肾病Ⅲ期患者随机分为两组,所有患者均采用胰岛素控制治疗,A组患者给予安慰剂,B组患者口服罗格列酮8mg。治疗前及治疗16周后检测血糖、糖化血红蛋白、血清超敏C反应蛋白(hs-CRP)、IL-6、TNF-α、基础肱动脉内径、内皮依赖性血流介导的舒张反应(FMD),以20例正常成人为对照。结果治疗前糖尿病肾病两组患者血清hs-CRP、IL-6和TNF-α水平明显高于正常对照组,其肱动脉内径(F0)和FMD明显低于对照组。治疗后,罗格列酮组的hs-CRP、IL-6和TNF-α水平明显降低,肱动脉内皮依赖性舒张功能明显增加,而安慰剂组无显著改变。结论早期糖尿病肾病患者存在炎症状态和血管内皮功能障碍,罗格列酮可减轻糖尿病肾病患者炎症状态,改善血管内皮功能,对早期糖尿病肾病患者有重要保护作用。
Objective To observe the effects of rosiglitazone on inflammatory factors and endothelial function in patients with early diabetic nephropathy (DN). Methods 50 patients with stage Ⅲ diabetic nephropathy were randomly divided into two groups, all patients were treated with insulin control, patients in group A were given placebo, and patients in group B were given oral rosiglitazone 8 mg. Blood glucose, glycosylated hemoglobin, serum hs-CRP, IL-6, TNF-α, basic brachial artery diameter, endothelium-dependent blood flow-mediated relaxation (FMD) were measured before treatment and 16 weeks after treatment ), With 20 normal adults as control. Results The serum levels of hs-CRP, IL-6 and TNF-α in patients with diabetic nephropathy before treatment were significantly higher than those in the normal control group, and the brachial artery diameter (F0) and FMD were significantly lower than those in the control group. After treatment, the levels of hs-CRP, IL-6 and TNF-α in rosiglitazone group were significantly decreased, while the brachial artery endothelium-dependent vasodilatation was significantly increased, while no significant changes were observed in placebo group. Conclusion There are inflammatory states and vascular endothelial dysfunction in patients with early diabetic nephropathy. Rosiglitazone can reduce the inflammatory state and improve the endothelial function in patients with diabetic nephropathy, which may have an important protective effect on patients with early diabetic nephropathy.