胰激肽原酶联合厄贝沙坦对2型糖尿病肾病患者肾功能及氧化应激的影响

王菲

[摘要] 目的 探讨胰激肽原酶联合厄贝沙坦对2型糖尿病肾病患者肾功能及氧化应激的影响。 方法 选择70例2型糖尿病肾病（DN）患者作为研究对象，随机分为观察组和对照组各35例。对照组给予口服厄贝沙坦片，观察组给予胰激肽原酶肠溶片联合应用厄贝沙坦片。比较两组患者治疗前后肾功能各指标、血清氧化应激指标和炎症因子指标变化。比较两组患者的不良发应发生率。结果 治疗3个月后，两组患者的24h尿蛋白、24h尿微量白蛋白、ACR和Ccr水平均显著低于治疗前，且观察组的各指标水平均显著低于对照组（P<0.05）。治疗后观察组血清氧化应激指标中 8-OHd G、MDA 值显著低于对照组，SOD、T-AOC 值显著高于对照组（P<0.05）。治疗后，两组患者的IL-6、ET、CRP、TNF-α水平均显著低于治疗前，且观察组的各指标水平均显著低于对照组（P<0.05）。 结论 胰激肽原酶联合厄贝沙坦能显著改善患者肾功能，降低氧化应激状态和炎症水平。

[关键词] 胰激肽原酶；厄贝沙坦；肾功能；糖尿病腎病；氧化应激

[中图分类号] R587.1 [文献标识码] B [文章编号] 2095-0616（2017）16-226-03

Effect of pancreatic kininogenase combined with irbesartan on renal function and oxidative stress of patients with type 2 diabetic nephropathy

WANG Fei

Jiangwan Town Community Health Service Center of Hongkou District， Shanghai 200080， China

[Abstract] Objective To study the effect of pancreatic kininogenase combined with irbesartan on renal function and oxidative stress of patients with type 2 diabetic nephropathy. Methods 70 patients with type 2 diabetic nephropathy （DN） were selected as the study subjects， which were randomly divided into observation group and control group of 35 cases. The control group was given oral irbesartan tablets， the observation group were given pancreatic kininase enteric-coated tablets combined with irbesartan tablets. The indexes of renal function， serum oxidative stress and inflammatory factors were compared before and after treatment. The incidence of adverse reactions was compared between the two groups. Results After 3 months of treatment， the levels of 24h urinary protein， 24h urinary albumin， ACR and Ccr were significantly lower in the two groups than before treatment（P<0.05）， and the level of observation group was significantly lower than that of the control group（P<0.05）. The levels of 8-OHd G and MDA in the observation group were significantly lower than those in the control group， and the values of SOD and T-AOC were significantly higher than those in the control group （P<0.05）. After treatment， the levels of IL-6， ET， CRP and TNF-α in the two groups were significantly lower than those in the control group（P<0.05）， and the level of observation group was significantly lower than that of the control group（P<0.05）. Conclusion Pancreatic kininogenase combined with irbesartan can significantly improve renal function， reduce oxidative stress and inflammation.

[Key words] Pancreatic kininogenase；Irbesartan； Renal function； Type 2 diabetic nephropathy；Oxidative stressendprint

糖尿病肾病（DN）是由于血糖导致的代谢异常而引起的肾脏损害，是糖尿病的常见并发症之一，近年來随着糖尿病发病率的逐渐升高，DN的发病率也逐年提升[1]。血管紧张素受体拮抗药在DN患者中的应用，能够降低糖尿病肾病患者蛋白尿[2]。

胰激肽原酶是激肽释放酶-激肽系统的重成分之一，在糖尿病肾病患者中广泛应用[3]，本研究旨在探讨胰激肽原酶联合厄贝沙坦对降低 DN 患者尿蛋白和氧化应激的影响。

1 资料与方法

1.1 一般资料

选择2016年1月～2017年1月我院收治的

DN患者70例作为研究对象，其中男36例，女34例，年龄52～79岁，平均（61.6±7.8）岁。病程5～22年，平均（9.5±1.2）年。全部患者均根据《中国 2 型糖尿病防治指南（2013版）》诊断为2 型糖尿病[4]，且符合DN的诊断标准：6个月内连续 2 次以上尿白蛋白排泄率（UAER）为20～200μg/min，糖化血红蛋白（ HbA1C） >7.0%、24h UMA 30～300 mg/24h。全……