舒洛地特对糖尿病肾病患者血和尿单核细胞趋化蛋白1的影响研究

摘要

Objective To investigate the effect of sulodexide on serum and urine MCP-1 in patients with type 2 diabetic nephropathy. Methods Enrolled 84 patients with type 2 diabetic nephropathy who received hospitalized treatment in the Department of Nephrology Jingzhou First People's Hospital from January 2012 to December 2013. The patients were divided into control group and observation group using random number table method, with each group 42 patients. Both groups were administrated with conventional subcutaneous infection of insulin to control blood glucose;the observation group was also administrated with the injection of 600 LSU sulodexide once per day for two weeks by the means of intravenous drip,and then the group was orally administrated with 250 LSU sulodexide soft capsule twice per day for ten weeks;the observation lasted for all together 12 weeks. The serum creatinine( Scr),urea nitrogen( BUN),fasting blood sugar( FBS),24 h urinary protein, coagulation function,serum and urine MCP-1 level were measured before and after treatment. Results Before treatment,the two groups were not significantly different(P>0. 05)in Scr,BUN,FBS,24 h urinary protein quantitation,PT,APTT,TT, FIB and serum and urine MCP-1 level. After treatment,the two groups were not significantly different(P >0. 05)in Scr, BUN,FBS,PT,APTT,TT and FIB;after treatment,the observation group was lower(P<0. 05)than the control group in 24 h urinary protein quantitation and serum and urine MCP-1 level. Conclusion Sulodexide can reduce urine protein excretion in patients with diabetic nephropathy,the mechanism of which may be related to the reduction of serum and urine MCP-1 secretion.%目的：探讨舒洛地特对糖尿病肾病患者血、尿单核细胞趋化蛋白1（ MCP-1）的影响。方法选取2012年1月—2013年12月荆州市第一人民医院肾内科住院治疗的糖尿病肾病患者84例，采用随机数字表法分为对照组和观察组，每组各42例。对照组采用常规皮下注射胰岛素控制血糖，观察组在对照组基础上加用舒洛地特注射液600 LSU，静脉滴注，1次/d，疗程2周；然后采用序贯疗法，舒洛地特软胶囊250 LSU，口服，2次/d，疗程10周，总观察时间为12周，测定患者治疗前后血肌酐、尿素氮、空腹血糖（ FBS ）、24 h 尿蛋白定量、凝血功能、血和尿MCP-1水平。结果治疗前，两组患者血肌酐、尿素氮、FBS、24 h尿蛋白定量、凝血酶原时间（ PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（FIB）、血和尿MCP-1水平比较，差异均无统计学意义（P >0.05）。治疗后，两组患者血肌酐、尿素氮、FBS、PT、APTT、TT、FIB比较，差异均无统计学意义（P>0.05）；治疗后，观察组患者24 h尿蛋白定量、血和尿MCP-1水平较对照组降低（ P<0.05）。结论舒洛地特能降低糖尿病肾病患者的蛋白尿，其机制可能与降低患者血、尿MCP-1水平有关。