米格列醇对糖尿病患者血浆TNF-α,IL-6水平的影响及其肾脏保护机制

摘要

目的：观察米格列醇对2型糖尿病患者的疗效及对患者肾功能的影响，观察其是否具有保护糖尿病患者肾脏的作用，并探讨这种保护作用是否与炎症因子抑制有关。方法：对根据WHO的诊断标准确诊为2型糖尿病的初治患者，先采用经饮食控制、运动治疗或同时进行1个月以上，对符合纳入标准的36例初治患者，随机分为米格列醇组和格列喹酮组，疗程3个月，治疗期间，每月随访1~2次，检测相关指标。结果：2种药物均具有较好的降血糖作用；组内比较结果显示，米格列醇和格列喹酮均可以降低早期糖尿病患者的尿微量白蛋白排泄率，差异有统计学意义(P＜0.05)，两组间比较，结果无统计学意义(P＞0.05)；两组治疗前后尿素氮、肌酐的差异均无显著性( P＞0.05)；治疗前后，两组间患者的血清TNF-α，IL-6指标差异均无统计学意义(P＞0.05)。两组分别做自身对照，患者的血清TNF-α， IL-6指标较治疗前明显降低，差异有统计学意义(P＜0.05)。结论：米格列醇具有良好降糖功能，还能降低糖尿病患者的尿微量白蛋白排泄率，对早期的DN患者起到一定的保护作用,这种保护机制与抑制TNF-α，IL-6激活有关。%Objective:To investigate the clinical efficacy of Miglitol in treating type 2 diabetes(T2DM) andits effect onkidney function, determine whether it has the expression of kidney protection and whether this protection function is related to the inhibition of inflammation factors.Methods:The inclusion criteria is as following:patients with T2DM were diagnosed according to the WHO criteria and never treated with antidiabetic agents, and treated by diet or exercise for more than 1 months.36 cases were recruited and randomly assigned to either Miglitol group or Gliquidone group. The patients were in treatment for 3 months with one or two times follow-up visit per month, and related index parameter were measured.Results:Both Miglitol and Gliquidone could decreased the glucose levels in patients,but there was no signiifcant difference between the two groups (P>0.05). Urinary albumin excretion ratedecreased obviouslyin both groupbefore treatment and later in each group,and within each group there were signiifcant differences (P0.05). Also there was no signiifcant difference in the level of urea nitrogen and creatinine after treatment in both groups (P>0.05). Before treatment and later in each group,the level of TNF-α,IL-6 in both group decreased obviously, there were signiifcant differences (P0.05).Conclusion:Miglitol not only has the excellent hypoglycemic function, can decrease urinary albumin excretion rate,but also can improve renal function and protect the kidney in patients with early DN. The mechanism may be related to the inhibition of TNF-αand IL-6 activation.