【2017年整理】肾炎康复片对糖尿病肾病早期患者尿足细胞标志蛋白Podocalyxin的影响.docVIP

肾炎康复片对糖尿病肾病早期患者尿足细胞顶端膜蛋白Podocalyxin的影响 武文斌 杨帅帅 (山东省潍坊市益都中心医院肾脏科 262500) 【摘要】目的 观察肾炎康复片对糖尿病肾病早期患者尿足细胞顶端膜蛋白Podocalyxin(PCX)的影响,以期阐明其部分治疗机理。方法 对32例糖尿病肾病早期患者服用肾炎康复片治疗(每日3次，每次5 粒)疗程为3个月。在治疗前和治疗3个月后分别监测尿足细胞顶端膜蛋白(PCX)、尿蛋白肌酐比值(ACR)、N-乙酰-β－Ｄ氨基葡萄糖苷酶（NAG）、可滴定酸(TA)、铵(NH4+)，然后对治疗前后进行疗效评价。结果 治疗3个月后，尿PCX较治疗前有非常显著降低（P0.01）；尿ACR和NAG较治疗前有明显减低(P0.05)；尿TA、NH4+与治疗前比较无统计学意义（P0.05）。结论 肾炎康复片对糖尿病肾病早期患者足细胞损伤有保护作用，从而有效减少蛋白尿,保护近端肾小管；但对远端肾小管影响不明显。 【关键词】糖尿病肾病；早期；肾炎康复片；尿足细胞顶端膜蛋白 Effect of Shenyankangfu Tablet on Podocalyxin in patients With early Diabetic Nephropathy Wuwenbin,yangshuaishuai (Yidu Centre Hospital of Weifang City in Shandong Province,Weifang 262500) 【Abstract】Objective Observing the effect of shenyankangfu tablet on Podocalyxin in patients with early Diabetic Nephropathy to clarify partial therapeutic mechanism.Mathods Give 32 of patients with early Diabetic Nephropathy shenyankangfu tablet to treat for 3 months（5 tablet thrice daily）.To detect the urinary podocyte apical membrane protein (PCX), Urine protein creatinine ratio（ACR）,Immunoglobulin G (IgG),N-acetyl-β-D-glucosaminidase (NAG), Titratable acid (TA), Ammonium (NH4+) before treatment and after 3 months of treatment，then evaluate the efficency of before and after treatment.Result Aftertreatment for 3months, PCX were very significantly dereased（P0.01）;ACR and NAG were significant decreased than before treatment(P0.05); there were no significant difference between before and after treatment in TA and NH4+(P0.05).Conclusions shenyankangfu tablet on patients with early Diabetic Nephropathy podocyte injury has a protective effect, thus effectively reducing proteinuria and protecting the proximal tubule, but have no effect on the distal tubule. 【Key words】Diabetic Nephropathy ,early,shenyankangfu tablet; urinary podocyte apical membrane protein 糖尿病在我国的发病率逐年升高，糖尿病肾病是其主要并发症，也是引起死亡的主要原因[1]。足细胞是组成肾小球滤过膜的主要成分，也是阻止大分子物质滤过的屏障，其肾脏受损时，足细胞表现为足突融合、收缩、胞体缩小等变化，继而与血管基底膜剥离，脱落至肾小囊中，随尿液排出[2]。足细胞脱落后大量蛋白质自肾小球渗漏，导致毛细血管袢透明变性，最终导致肾小球硬化[3]。足细胞表面覆盖一