硫辛酸对糖尿病肾病Ⅲ期患者PCX 和VEGF 的影响

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。

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

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.