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目的探讨丹参多酚酸盐治疗对早期糖尿病肾病(DN)患者血清炎性因子及肾血管内皮功能的影响。方法选择2012年9月至2014年9月在新疆维吾尔自治区人民医院住院治疗的早期DN患者118例为研究对象,采用随机数字表法将患者分为对照组和丹参多酚酸盐组,每组59例。对照组给予胰岛素控制血糖、尼莫地平控制血压治疗,丹参多酚酸盐组在对照组治疗的基础上加入丹参多酚酸盐治疗,每次200 mg,静脉滴注,每日1次。治疗14 d后比较两组患者血清炎性因子、肾血管内皮功能及胰岛素抵抗水平。结果治疗后,丹参多酚酸盐组患者血清高敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)的水平显著低于对照组[(9.14±1.73)mg/L比(13.82±2.63)mg/L,(13.02±1.63)ng/L比(35.28±5.81)ng/L、(15.92±2.74)ng/L比(31.27±4.72)ng/L](P<0.05);内皮微粒、内皮素1的水平显著低于对照组[(573.29±72.18)个/μL比(852.18±115.37)个/μL,(101.82±9.53)ng/L比(231.76±15.62)ng/L],血管扩张反应(FMD)显著高于对照组[(10.87±2.18)%比(7.12±0.83)%](P<0.05),HOMA-IR显著低于对照组(2.32±0.45比3.09±0.53),ISI显著高于对照组(-3.41±0.57比-4.39±0.63)(P<0.05)。结论丹参多酚酸盐治疗有助于缓解全身炎性状态、优化肾血管内皮功能、降低胰岛素抵抗,是治疗早期DN的理想方法。
Objective To investigate the effect of Salviae miltiorrhizae on the serum inflammatory factors and renal vascular endothelial function in patients with early diabetic nephropathy (DN). Methods A total of 118 early DN patients hospitalized in People’s Hospital of Xinjiang Uyghur Autonomous Region from September 2012 to September 2014 were selected as the study subjects. Patients were divided into control group and Salviae polyphenols group by random number table. Each group 59 cases. The control group was given insulin to control blood sugar and nimodipine to control blood pressure. Salviae miltiorrhizae polyphenols group was treated with Salviae polyphenols on the basis of the control group, 200 mg each time, once daily. Serum inflammatory factors, renal vascular endothelial function and insulin resistance were compared between the two groups after 14 days of treatment. Results After treatment, the levels of hs-CRP, TNF-α and IL-6 in salvianolate group were significantly lower than those in control group [( (13.22 ± 2.63) ng / L (35.28 ± 5.81) ng / L, (15.92 ± 2.74) ng / L vs (31.27 ± 4.72) ng / L vs / L] (P <0.05). The levels of endothelins and endothelin 1 were significantly lower than that of the control group [(573.29 ± 72.18) / μL (852.18 ± 115.37) /μL, (101.82 ± 9.53) ng / L (231.76 ± 15.62) ng / L], and the vasodilation response (FMD) was significantly higher than that of the control group [(10.87 ± 2.18)% vs 7.12 ± 0.83% (2.32 ± 0.45 vs 3.09 ± 0.53), ISI was significantly higher than the control group (-3.41 ± 0.57 vs -4.39 ± 0.63) (P <0.05). Conclusion Salviae miltiorrhiza polyphenols treatment can relieve systemic inflammatory state, optimize renal vascular endothelial function, reduce insulin resistance, which is the ideal method for the treatment of early DN.