硫辛酸对糖尿病肾病Ⅲ期患者PCX 和VEGF 的影响

Effect of thioctic acid on urinary podocalyxin and plasma VEGF in patients with stage III diabetic nephropathy

摘要:

目的 探讨糖尿病肾病（DN）Ⅲ期患者尿足细胞标志蛋白（PCX）及血管内皮生长因子（VEGF）水平的变化及α- 硫辛酸（ALA）对其的影响。方法 122 例2 型糖尿病患者根据24 h 尿白蛋白排泄率分为单纯糖尿病组（SDM 组）62 例、DN Ⅲ期组（NA 组）60 例。NA 组随机分为ALA 治疗组（NA Ⅰ组30 例）和常规治疗组（NA Ⅱ 30 例），另选正常对照者（NC 组）60 例。比较ALA 治疗前及治疗2 周后丙二醛（MDA）、超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-px）、尿PCX 及血VEGF 的变化。结果 NA Ⅰ组经ALA 治疗后MDA、UAER、PCX 及VEGF 较治疗前下降（P <0.05），SOD 及GSH-px 较治疗前上升（P <0.05）。结论 ALA 可通过抗氧化应激保护DN Ⅲ期患者肾小球足细胞。

Abstract:

Objective To investigate the changes of urinary podocalyxin (PCX) and vascular endothelial growth factor (VEGF) in the patients with diabetic nephropathy (DN) at stage III and the effect of alpha-lipoic acid (ALA) on them. Methods According to the uriary albumin excretion rate (UAER), 182 participants were divided into three groups as: simple diabetes mellitus group (SDM, n = 62), DN at stage III group (NA, n = 60), and normal control group (NC, n = 60). Then the NA group was randomly divided into ALA treatment group (NA I,n = 30) and conventional treatment group (NA II, n = 30). The levels of MDA, SOD, GSH-px, urinary PCX and serum VEGF were determined at baseline and 2 weeks after treatment. Results The level of MDA after ALA treatment was lower than that before ALA treatment in the NA I group (P < 0.05). The levels of SOD and GSH-px were higher than those before treatment (P < 0.05). The levels of urinary PCX and serum VEGF were lower after treament(P < 0.05). Conclusions ALA can provide some protection against glomerular podocyte injury, which may be related to its effect in alleviating enhanced oxidative stress in DN at stage III.