糖尿病肾病者血清趋化因子与氧化应激水平的相关性.doc

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1、糖尿病肾病患者血清趋化因子与氧化应激水平的相关性及α-硫辛酸的治疗作用【摘要】目的观察血清趋化因子及氧化应激指标在糖尿病肾病（DN）不同时期的差异及α-硫辛酸治疗后水平的变化，探讨趋化因子与氧化应激在DN中的相关性及抗氧化应激治疗对二者的影响。方法选择2型糖尿病患者100例，根据24小时尿白蛋白定量（24h-UAL）水平分为正常组（24h-UAL<30mg/24h）、早期DN组（24h-UAL30~300mg/24h）和临床DN组（24h-UAL>300mg/24h），三组患者均给予α-硫辛酸治疗4周，测定各组治疗前后血清趋化因子（FKN、MCP

2、-1）、氧化应激指标（GSH-PX、SOD、MDA）、FPG、2hPG、HbA1C水平及24h-UAL变化。另选30例健康体检者为对照组。结果（1）对照组GSH-PX及SOD水平显著高于糖尿病组，血清趋化因子与MDA水平则显著低于糖尿病组；三组治疗后血清趋化因子与MDA水平均较治疗前显著下降，GSH-PX及SOD水平则显著升高；早期组及临床组治疗后24-UAL较治疗前显著降低；治疗前后临床DN组血清FKN、MCP-1及MDA水平均明显高于正常组和早期DN组，GSH-PX及SOD水平则显著低于另两组（P<0.05）；（2）趋化因子与MDA、24h-

3、UAL、FPG、2hPG及HbA1C呈正相关，与GSH-PX和SOD呈负相关；MDA与趋化因子、24h-UAL、FPG、2hPG及HbA1C呈正相关，GSH-PX和SOD与上述指标呈负相关。结论DN患者血清趋化因子及氧化应激指标水平与24h-UAL及血糖水平显著相关，抗氧化应激治疗能降低血清趋化因子水平，减少尿蛋白排泄，从而延缓DN的进展。【关键词】Fractalkine；MCP-1；氧化应激；糖尿病肾病；α-硫辛酸Thecorrelationofchemotacticfactorsandoxidativestressmarkersindiabe

4、ticnephropathyandtheeffectsofα-lipoicacidtothem[Abstract]ObjectivesToobservethedifferencesbetweenserumchemotacticfactorsandoxidativestressmarkersindifferentperiodsofdiabeticnephropathyandthechangesofbothaftertherapyofα-lipoicacid.Toexplorethecorrelationofchemotacticfactorsand

5、oxidativestressmarkersindiabeticnephropathyandtheeffectsofα-lipoicacidtothem.Methods100patientswithtype2diabeticmellituswererandomlydividedintonormalgroup,earlydiabeticnephropathygroupandclinicaldiabeticnephropathygroup,whichwereaccordingto24hoururinaryalbumin.ChangesofFKN,MC

6、P-1,GSH-PX,SOD,MDA,24h-UAL,FPG,2hPG,HbA1Cand24h-UALbeforeandaftertreatmentofα-lipoicacidforforeweeksinthreegroupswereobserved.Another30healthypersonswerechosenascontrolgroup.Results1.SerumGSH-PXandSODincontrolgroupwereobviouslyhigherthanotherthreegroups,atthesametime,serumche

7、motacticfactorsandMDAwerelowerthandiabeticgroups.LevelsofSerumchemotacticfactorsandMDAweredecreasedsignificantlyaftertreatmentinallgroups,whichofGSH-PXandSODwereinoppositeresults.24-UALwaslowerthanbeforeinnormalgroupandearlydiabeticnephropathygroup.LevelsofFKN,MCP-1andMDAindi

8、abeticnephropathygroupwereobviouslyhigherthanthatinothertwogroupsbef