缬沙坦治疗对糖尿病肾病患者氧化应激的影响 - 第三军医大学学报.doc

氯沙坦治疗对糖尿病肾病患者氧化应激的影响 金惠男 重庆市第九人民医院肾内科 400000 摘要 目的 探讨氯沙坦治疗对糖尿病肾病患者体内氧化应激的影响。 方法 选择确诊的糖尿病肾病患者64例，在常规降糖治疗的基础上给予氯沙坦治疗（口服，100mg/d），另选择健康体检者20例作为正常对照组。全自动生化测定仪测定血糖、血脂，酶联免疫法测定血ox-LDL和尿中MCP-1含量，分光光度法测定AOPPs、SOD、MDA含量，免疫比色法测定24h尿蛋白排泄率（UAME）。结果 ⑴与正常人组比较，糖尿病肾病患者血清中SOD活性显著降低，MDA、ox-LDL和AOPP含量显著升高。氯沙坦治疗后，血清中SOD活性显著升高、MDA、ox-LDL和AOPP含量显著降低。⑵与正常人组比较，糖尿病肾病患者尿中SOD活性显著下降，而MDA和单核细胞趋化蛋白1（MCP-1）含量显著升高。氯沙坦治疗后，不仅尿蛋白排泄显著减少，尿中SOD活性明显升高，MDA和MCP-1含量明显降低。⑶血清中MDA、ox-LDL、AOPP和尿中MCP-1含量与尿蛋白排泄率（UAME）呈显著正相关（相关系数分别为0.88、0.76、0.78、0.81，P值均小于0.05），而SOD与UME呈显著负相关（相关系数为-0.79，P0.05）。 结论 氯沙坦治疗可显著减少DN患者尿蛋白排泄，可能与其抗氧化抗炎机制有关。 关键词 糖尿病肾病 氯沙坦 氧化应激 炎症 Effect of Losartan treatment on oxidative stress of patients with diabetes nephropathy Jin Huinan nineth Hospital of Chongqing (400000) 【Abstract】Object To investigate the effect of Losartan on the oxidative stress in patients with diabetic nephropathy. Method Sixty four patients with diabetic nephropathy were enrolled to be treated with Losartan（orally，100mg/d）in addition to the routine treatment regulating blood glucose, and 20 health person were selected as control. The level of blood glucose(BG),triglyceride,total cholesterol, low density lipoprotein(LDL) and 24h urinary protein excretion rate (UAER) were measured by HITACHI automatical.The concentration of serum or urine ox-LDL and MCP-1 were determined by ELISA. The concentration of serum AOPPs and urine malonaldehyde(MDA) and the activity of serum or urine SuperoxideDismutase(SOD) were detected by spectrophotography. Results ⑴Comparison with health control, the levels of serum MDA、ox-LDL and AOPP , but the activity of serum SOD was decreased markedly in ptients with diabetes nephropathy. These changes could be reversed by treatment with Losantan for 3 month. ⑵The results also showed higher concentrations of urine MDA and MCP-1 as well as lower urine SOD activity in the DN patients compared with control, and it were also reversed by treatment with Losantan for 3 month. ⑶ Relevance analysis demonst