贝那普利联合缬沙坦对糖尿病肾病患者血清MCP-1及hs—CRP的影响

【目的】探讨贝那普利联合缬沙坦治疗2型糖尿病肾病（DN）对患者血清单核细胞趋化蛋白-1（MCP-1）及超敏C反应蛋白（hsCRP）的影响。【方法】选择本院临床确诊为DN的53例患者分为常规组（n=20）、贝那普利联合缬沙坦治疗组（联合组，n=33），另设20例健康体检者作为正常对照组（对照组，n=20），常规组患者给予常规治疗，联合组在常规组治疗基础上加用贝那普利5mg／d、缬沙坦80mg／d，观察6个月，采用双抗体夹心酶联吸附法（ELISA）测定两组患者治疗前后及对照组血清MCP-1及尿微量白蛋白（mA1b），生化分析仪检测血肌酐（SCr）、血糖（FBG）、糖化血红蛋白（HbA1c）、hs-CRP。相关分析MCP-1与FBG、HbA1c、SCr、hs—CRP及尿mA1b之间的关系。【结果】①治疗前常规组、联合组患者血清SCr、MCP—1、hsCRP、FBG、HbA1c升高，皆显著高于对照组（P〈0．01）；治疗后，两组上述指标较治疗前不同程度下降（P〈0．05、0．01）；联合组降低幅度显著高于常规组（P〈0．05）。②相关分析表明血浆MCP-1水平与SCr、HbA1c及尿mA1b呈显著负相关（r=-0．74、-0．69、-0．75，P〈0．05、0．01）；与hsCRP呈显著正相关（r=0．88，P〈0．01）。【结论】贝那普利联合缬沙坦治疗可通过抑制DN患者的炎症反应起到肾脏保护作用。

Influence of Benazepril and Valsartan Treatment an MCP-1 and hs-CRP in Patients with Diabetic Nephropathy

[Objective]To study the effect of combination therapy with benazepril and valsartan on mono cyte chemoattraetant protein-1 （MCP-1） and high sensitivity C-reactive protein （hs-CRP） in patients with dia betic nephropathy （DN）. [Methods] A total of 53 DN patients were randomly divided into two groups. In Group DN, 20 DN patients received normal treatment. In Group combination therapy with benazepril and val sartan, 33 DN patients received normal treatment plus combination therapy with benazepril （5 mg/d） and valsartan （80 mg/d） for 6 months. Twenty healthy individuals were selected as normal control group （Group C）. The serum levels of MCP-1 and urinary micro-albuminuria（mAlb） were detected with ELISA, and serum glucose（FBG）, creatinine （Ser）, glycosylated hemoglobin （HbAlc） and hs-CRP were measured by automatic biochemistry analysis apparatus in three groups before and after the treatment. Their relationship was analyzed. [Results]Before treatment, the serum levels of Ser, MCP-1, hs-CRP, FBG and HbAlc increased significantly in both Group DN and Group combination therapy, and were higher than those in Group C （ P 〈0.01）. After treatment, above indicators reduced significantly in both groups （ P 〈0.01, 0.05）, and were higher in Group C than those in both Group DN and Group combination therapy. Correlation analysis showed that serum levels of MCP-1 was positively related to hs CRP, and the coefficient correlation was 0.88 （ P 〈0.01）. Serum lev els of MCP-1 were negatively related to Scr, mA1b for 24 hours and HbAlc, and the coefficient correlation was -0.74, -0.69 and 0.75, respectively （ P 〈0.05, 0.01）. [Conclusion]The serum levels of MCP-1 and hs-CRP is significantly increased in diabetic nephropathy patients which suggests that the inflammation partici pates the development of DN. Combination therapy with benazepril and valsartan may improve renal function in diabetic patients through inhibiting the activity of MCP-1.