胰激肽原酶联合舒洛地特治疗糖尿病肾病的疗效及对氧化炎症状态、足细胞损伤的影响

黄强 韩强

【摘要】 目的：探讨胰激肽原酶联合舒洛地特治疗糖尿病肾病（DN）的效果，分析患者氧化炎症状态、足细胞损伤程度的变化。方法：选取2016年8月-2018年8月在本院接受治疗的DN患者96例，按随机数字表法分为对照组（n=48，接受常规+胰激肽原酶治疗）、研究组（n=48，接受常规+胰激肽原酶+舒洛地特治疗）。对比两组近期疗效、血清氧化应激指标及炎症指标含量、尿液足细胞损伤指标（Podocin、Nephrin、Mindin）水平的差异。结果：治疗后，研究组治疗总有效率高于对照组（P<0.05）;血清中高级氧化蛋白产物（AOPPs）、白介素-1（IL-1）、白介素-18（IL-18）含量均低于对照组（P<0.05），超氧化物歧化酶（SOD）含量高于对照组（P<0.05）;尿液中Podocin、Nephrin、Mindin水平均低于对照组（P<0.05）。结论：胰激肽原酶联合舒洛地特用于DN治疗，有助于提升疗效并减轻机体氧化炎症及足细胞损伤。

【关键词】 糖尿病肾病; 胰激肽原酶; 舒洛地特; 氧化应激; 炎症反应; 足细胞损伤

【Abstract】 Objective：To investigate the effect of Pancreatic Kallikrein combined with Sulodexide in the treatment of diabetic nephropathy（DN），and analyze the changes of oxidative inflammation and podocyte damage.Method：96 cases of DN patients from August 2016 to August 2018 were divided into control group（n=48，routine treatment + Pancreatic Kallikrein therapy），research group（n=48，routine treatment + Pancreatic Kallikrein + Sulodexide therapy）by random number table method.The short-term efficacy，serum contents of oxidative stress indicators and inflammatory indicators，indicators of urinary podocyte injury were compared between two groups.Result：After treatment，the total effective rate of the research group group was higher than that in control group（P<0.05），serum contents of advanced oxidative protein products（AOPPs），interleukin-1（IL-1），interleukin-18（IL-18）of the research group were lower than those in control group（P<0.05），content of superoxide dismutase（SOD）of the research group was higher than that in control group（P<0.05），levels of Podocin，Nephrin and Mindin in urine of the research group were lower than those in control group（P<0.05）.Conclusion：Pancreatic Kallikrein combined with Sulodexide in the treatment of DN can improve the therapeutic effect and reduce oxidative inflammation and podocyte injury.

【Key words】 Diabetic nephropathy; Pancreatic Kallikrein; Sulodexide; Oxidative stress; Inflammatory reaction; Podocyte injuryFirst-authors address：Affiliated Xiaolan Hospital of Southern Medical University，Zhongshan 528415，China

doi：10.3969/j.issn.1674-4985.2019.15.017

糖尿病腎病（DN）是国内终末期肾病的第二位病因，存在复杂的代谢异常、治疗难度较其他肾病更大[1-2]。胰激肽原酶是具有扩张血管、改善血液循环和微循环等作用的蛋白水解酶，已经被证实可优化DN患者病情[3]。舒洛地特是剂量依赖性的抗血栓药物，通过抑制活化X因子发挥作用，已经在原发性肾小球肾炎、IgA肾病等肾脏疾患的治疗中获得成功应用，推测其可能在DN的病情优化中也能发挥积极作用[4-5]。文中将舒洛地特联合胰激肽原酶用于DN患者的治疗，探讨其应用价值及安全性等问题，为后续同类患者的治疗方案选择提供新思路。现报道如下。……