百令胶囊对早期糖尿病肾病氧化应激的影响

糖尿病肾病(DN)是糖尿病(DM)的常见并发症之一,在DM病人发生率约为20%～40%〔1,2〕,最终导致肾衰竭。由于DM肾脏病变为慢性进行性损害,症状出现较晚,一般出现尿蛋白时病程多在10年以上,一旦出现持续性蛋白尿,肾功能将不可遏制地进行性下降〔3〕。因此,早期治疗可以延缓DN进展,     

百令胶囊治疗早期糖尿病肾病的临床疗效观察

目的观察百令胶囊治疗早期糖尿病肾病的临床疗效。方法 40例早期糖尿病肾病患者,随机分为观察组和对照组各20例。均给予常规药物厄贝沙坦治疗,观察组给予百令胶囊治疗,8周后评价临床效果。结果 8周后与对照组比较,观察组24 h尿白蛋白定量下降,差异有统计学意义(P 0. 05)。结论百令胶囊可有效减少尿蛋白,对于早期糖尿病肾病具有良好治疗效果。     

百令胶囊联合阿托伐他汀用于老年2型糖尿病肾病效果观察

目的 观察百令胶囊联合阿托伐他汀用于治疗老年2型糖尿病肾病的临床效果.方法 将68例老年2型糖尿病肾病患者随机分为观察组及对照组,每组各34例.两组均予糖尿病常规治疗并口服阿托伐他汀20 mg/d;在此基础上观察组加服百令胶囊2.0g/次,3次/d.检测两组患者治疗前及治疗16周后的血脂、24h尿蛋白定量(UTP/24 h)、超敏C反应蛋白(hs-CRP)、肌酐(sCr)、尿酸(UA).结果 治疗后两组血脂、URP/24 h、hs-CRP、sCr、UA均较治疗前降低(P均＜0.05);与对照组比较观察组降低更明显(P均＜0.05).结论 阿托伐他汀联合百令胶囊能显著改善老年2型糖尿病肾病的脂代谢紊乱及微炎症状态,减轻蛋白尿,延缓肾功能减退.     

阿托伐他汀联合百令胶囊对糖尿病肾病微炎症状态的影响

微炎症状态是指机体受各种因素刺激而发生的以促炎症因子释放为中心的炎症反应.研究提示2型糖尿病患者体内C反应蛋白(CRP)和肿瘤坏死因子(TNF)-α水平明显升高,体内存在炎症反应.[1]我们通过定期测定微炎症指标,观察阿托伐他汀及百令胶囊对糖尿病肾病(DKD)患者微炎症状态和脂代谢的影响.     

百令胶囊联合坎地沙坦酯治疗早期糖尿病肾病的临床观察

目的探讨百令胶囊联合坎地沙坦酯治疗糖尿病肾病的临床效果。方法将52例Ⅲ期糖尿病肾病患者随机分为两组：观察组（26例）患者给予百令胶囊联合坎地沙坦酯治疗;对照组（26例）患者给予坎地沙坦酯治疗。两组患者均给予胰岛素有效控制血糖,空腹血糖（FBS）〈8mmol／L、餐后血糖（PBS）〈10mmol／L。疗程4周,观察比较两组患者在接受治疗的前后血肌苷（ca）、蛋白尿水平及尿白蛋白排出率（UAER）。结果观察组患者的尿蛋白、UAER的水平低于对照组,两者的差异均具有明显的统计学意义（P〈0．05）;两组患者的血CR水平差异无统计学意义（P〉0．05）。结论百令胶囊联合坎地沙坦酯糖尿病肾病患者,比单用坎地沙坦酯治疗更有效地控制糖尿病肾病患者的蛋白尿。     

RAAS阻断剂联合百令胶囊治疗早期糖尿病肾病疗效和血糖水平的影响

目的 分析RAAS阻断剂联合百令胶囊治疗早期糖尿病肾病疗效和对血糖水平的影响.方法 选取2019年7月—2021年6月该院收治符合研究条件的早期糖尿病肾病患者84例,依据用药不同分为对比组、研究组,各42例,观察评估临床疗效、血糖水平、炎性因子、肾功能指标.结果 研究组总有效率(88.10％)明显较对比组(69.05％...     

百令胶囊联合羟苯磺酸钙治疗糖尿病肾病的疗效分析

目的 探讨糖尿病肾病患者实施羟苯磺酸钙、百令胶囊联合用药治疗的效果.方法 选取2019年3月—2021年3月于该院门诊接诊治疗的糖尿病肾病患者84例,根据单双号抽签形式分作观察组(单号,42例)与对照组(双号,42例),对照组实施常规治疗,观察组在其基础上采用羟苯磺酸钙、百令胶囊联合治疗,比较临床治疗效果,检测对比两组...     

百令胶囊加雷公藤多甙片治疗糖尿病肾病Ⅳ期观察

40例患者随机分为对照组给以综合治疗，治疗组另加以百令胶囊、雷公藤多甙。结果治疗组尿蛋白明显减轻，优于对照组（P〈0.01）。结论百令胶囊加雷公藤多甙治疗糖尿病肾病IV期可以减少蛋白尿的漏出。     

百令胶囊加雷公藤多甙片治疗糖尿病肾病IV期观察

40例患者随机分为对照组给以综合治疗，治疗组另加以百令胶囊、雷公藤多甙。结果治疗组尿蛋白明显减轻，优于对照组（P〈0.01）。结论百令胶囊加雷公藤多甙治疗糖尿病肾病IV期可以减少蛋白尿的漏出。     

百令胶囊与胰激肽原酶联合治疗早期糖尿病肾病的临床观察

目的观察百令胶囊与胰激肽原酶联合治疗早期糖尿病肾病(EDN)的疗效以及治疗前后尿微量白蛋白的变化。方法将50例早期EDN患者随机分为两组,对照组在常规治疗基础上予胰激肽原酶240U,3次/d,口服;联合治疗组在对照组基础上加用百令胶囊1.0g,3次/d,口服,12周和6个月后观察联合治疗组与对照组治疗前后24h尿微量白蛋白排泄率(UAER)的变化。结果治疗后12周,两组患者治疗前后24h UAER均有较明显下降(P0.05);治疗后6个月,对照组患者治疗前后24h UAER有一定的下降(P0.05),联合组患者治疗前后24h UAER有明显的下降(P0.01);治疗后12周和6个月组间比较,联合组24h UAER与对照组比较差异有统计学意义(P0.05)。结论百令胶囊与胰激肽原酶联合应用能明显降低EDN患者的尿微量白蛋白排泄,可以有效延缓DN的讲展。     

2型糖尿病合并糖尿病肾病脂联素水平变化及与血管内皮功能的关系

目的探讨糖尿病肾病患者血清脂联素水平的变化,及与血管内皮功能的关系。方法 50例无明显临床大血管并发症的2型糖尿病患者,按24 h尿白蛋白排出量分为正常白蛋白尿组、微量白蛋白尿组及大量白蛋白尿组。检测血清脂联素、可溶性血管细胞黏附分子1、生物化学指标、肱动脉内皮依赖性舒张功能(FMD)、含服硝酸甘油后肱动脉内皮依赖性舒张功能(NID)、心脏结构参数及颈动脉内膜-中膜厚度。结果大量白蛋白尿组脂联素水平是正常白蛋白尿组的4倍,是微量白蛋白尿组的2倍(P<0.01和P<0.05)。微量白蛋白尿组脂联素水平比正常白蛋白尿组升高(P<0.05)。脂联素/血肌酐在三组中有同样的变化(均P<0.05)。大量白蛋白尿组和微量白蛋白尿组可溶性血管细胞黏附分子1均高于正常白蛋白尿组(P<0.01和P<0.05)。大量白蛋白尿组FMD、NID随脂联素水平的增加而下降(P<0.05)。颈动脉内膜-中膜厚度在三组间无统计学差异。脂联素与可溶性血管细胞黏附分子1、24 h尿白蛋白排出量、血肌酐、左心室后壁厚度、内膜-中膜厚度呈正相关(r值分别为0.338、0.704、0.470、0.331、0.324,P<0.05),与FMD、NID呈显著负相关(r值为-0.397、-0.413,P<0.01)。结论糖尿病肾病伴随高脂联素血症,且与血管内皮功能损害密切相关。脂联素可作为糖尿病肾病患者早期血管内皮功能障碍的预测指标。     

Renal Function Alters Antihypertensive Regimens in Type 2 Diabetic Patients

To determine the prevalence of multidrug antihypertensive therapy (MDAT), records were evaluated for patients with both type 2 diabetes and hypertension during a 5‐year period at Joslin Diabetes Center. Hypertension control was defined as requiring multiple drugs if three or more antihypertensive drugs were used, one of which must be a diuretic (unless patient is receiving dialysis), or use of four or more antihypertensive drugs, one of which a diuretic (unless patient is receiving dialysis) was established. The objective was to determine the prevalence of multidrug requirement for hypertensive therapy in relationship to four levels of renal function estimated by the Modification of Diet in Renal Disease formula for glomerular filtration rate (GFR). Among 10,151 patients, mean estimated GFR was 80 mL/min. Using standard (ASN) classification for renal function, we noted the following breakdown of MDAT use:

维生素D治疗对2型糖尿病合并呼吸道感染患者细胞免疫功能的影响研究

目的探讨维生素D治疗对2型糖尿病合并呼吸道感染患者细胞免疫功能的影响。方法选取唐山市协和医院2013年1—3月收治的2型糖尿病合并呼吸道感染患者60例,随机分为对照组和观察组,每组30例。对照组患者在常规治疗基础上给予安慰剂,观察组患者在常规治疗基础上给予骨化三醇胶丸;两组患者均连续治疗4周。观察两组患者治疗前后骨代谢指标(血清钙、磷、碱性磷酸酶、25羟维生素D3水平)和细胞免疫指标(CD+3、CD+4、CD+8细胞分数及CD+4/CD+8比值)变化。结果两组患者治疗前血清钙、磷、碱性磷酸酶、25羟维生素D3水平及治疗后血清磷、碱性磷酸酶水平比较,差异均无统计学意义(P>0.05);观察组患者治疗后血清钙、25羟维生素D3水平高于对照组(P<0.05)。两组患者治疗前CD+3、CD+4、CD+8细胞分数及CD+4/CD+8比值和治疗后CD+4、CD+8细胞分数比较,差异均无统计学意义(P>0.05);观察组患者治疗后CD+3细胞分数及CD+4/CD+8比值高于对照组(P<0.05)。结论维生素D治疗可增强2型糖尿病合并呼吸道感染患者细胞免疫功能,且安全性较高。     

促红细胞生成素对2型糖尿病大鼠肾损伤的保护作用

目的 探讨促红细胞生成素(EPO)对2型糖尿病大鼠肾损伤的保护作用.方法 4周龄雄性 SD大鼠60只随机分为2组.正常对照组10只,普通饲料喂养;糖尿病模型组 50只,单侧肾切除手术 2 周后,高脂饲料喂养,喂养4周后尾静脉注射小剂量链脲佐菌素(STZ) 35 mg/kg,注射 STZ 30d后,将其随机分为实验组和治疗组,治疗组给予促红细胞生成素300U/kg腹腔注射.30d后,测量24h尿蛋白含量,并用免疫组化染色观察肾脏 CD34 的阳性表达.结果 实验组及治疗组24h尿蛋白含量及肾脏CD34的表达均高于对照组(P＜0.05),治疗组24h尿蛋白含量及肾脏CD34的表达均低于实验组(P＜0.05).结论 EPO对2型糖尿病大鼠的肾损伤具有保护作用.     

替米沙坦联合苯那普利对糖尿病肾病患者的肾保护作用

目的探讨替米沙坦联合苯那普利治疗糖尿病肾病（DN）的临床疗效及安全性,为临床合理选择用药提供依据。方法80例2型糖尿病肾病患者随机分为替米沙坦组、联合治疗组各40例,两组患者均给予常规降血糖治疗,包括严格控制饮食、适当体育运动、降血脂、口服降血糖药物,部分患者注射胰岛素制剂,使HbA1c在6．5g／L以下。治疗期间均停用其他降压药物。替米沙坦组用替米沙坦片60mg／d;联合治疗组用替米沙坦片30mg／d,苯那普利片10mg／d,疗程均为3月。观察治疗前后各组血肌酐（Scr）、糖化血红蛋白（HBA1c）、尿中总蛋白（TP）的变化。结果两组患者治疗前HbA1c、TP、肌酐（SCr）水平间差异无统计学意义（P〉0．05）。疗程中未发现严重不良反应。治疗后两组HbA1c间差异无统计学意义（P〉0．05）。治疗后两组患者尿TP、血Scr间差异均有统计学意义（P〈0．05）。结论替米沙坦联合苯那普利治疗糖尿病肾病更有效、更合理,并无明显不良反应。     

Effects of Calcium Channel Blockers on Proteinuria in Patients With Diabetic Nephropathy

Diabetic nephropathy management should include the use of an angiotensin‐converting enzyme inhibitor (ACEI) or an angiotensin receptor blocker with additional antihypertensive medications to reduce proteinuria and cardiovascular events. Some studies suggest that adding a nondihydropyridine rather than a dihydropyridine calcium channel blocker (CCB) may more effectively lower proteinuria. We hypothesized that a trandolapril/verapamil SR (T/V) fixed‐dose combination (FDC) was superior to a benazepril/amlodipine (B/A) FDC for reducing albuminuria in 304 hypertensive diabetic nephropathy patients when treated for 36 weeks. No statistically significant differences were observed between groups in the primary end point; adjusted percentage change in urinary albumin/creatinine ratio (UACR), which increased (mean T/V, 29.29%; mean B/A, 8.49%; difference, 20.80%; P=.34); or in change in absolute UACR, which decreased (mean [g/g] T/V, −0.11; mean [g/g] B/A, −0.08; difference −0.03; P=.78). There were significant reductions in log UACR (mean change in T/V, −0.28; P<.01; mean change in B/A, −0.31; P<.001) and diastolic blood pressure in both groups and in systolic blood pressure in the B/A group. T/V was not superior to B/A for reducing UACR. Both ACEI/CCB FDCs may reduce albuminuria; in the case of T/V, this appears to be independent of systolic blood pressure reduction in patients who had previously been treated and had baseline blood pressure levels of 142/77 mm Hg.

Diabetic nephropathy, the leading cause of end‐stage renal disease, is characterized by persistent albuminuria, hypertension, or decline in glomerular filtration rate and excessive cardiovascular morbidity and mortality. ^{1 , 2 , 3} Cumulative incidence of diabetic nephropathy is 25%–40% after 25 years in type 1 and 2 diabetics. Within 5 years of onset of overt proteinuria, end‐stage renal disease develops in up to 50% of patients. Clinical trials have demonstrated that hypertension and increased activity of the renin‐angiotensin‐aldosterone system (RAAS) are major factors responsible for kidney damage and cardiovascular events in diabetic nephropathy and that antihypertensive regimens that include RAAS‐blocking drugs, angiotensin‐converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), or β‐blockers confer long‐term renoprotection. ^{4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13} Similar blood pressure (BP) reduction by other antihypertensive agents may not result in comparable renoprotection. In studies comparing calcium channel blockers (CCBs) to ACEIs or ARBs in patients with nephropathy, renoprotection by CCBs was inferior. ^{12 , 14 , 15} An analysis of studies evaluating the effect of CCBs in diabetic and nondiabetic nephropathy concluded that nondihydropyridine (NDHP) CCBs (verapamil, diltiazem) may confer greater reduction of proteinuria than dihydropyridine (DHP) CCBs (amlodipine, felodipine, nisoldipine, etc), ¹⁵ even with comparable BP reduction, suggesting that the renoprotective effect of NDHP CCBs may be due to actions other than BP effects. However, these results occurred in patients who did not receive an ARB or an ACEI as baseline therapy. In one study, an NDHP CCB was superior to a DHP CCB for reducing albuminuria in type 2 diabetics with nephropathy despite similar BP control. ¹⁶ Guidelines recommend RAAS inhibitors as first‐step therapy for diabetic nephropathy. ¹⁷ There are no prior studies directly comparing an NDHP CCB to a DHP CCB added to an RAAS inhibitor. We tested the hypothesis that the fixed‐dose combination (FDC) of an ACEI and an NDHP CCB is superior to the FDC of an ACEI and a DHP CCB for reducing albuminuria in hypertensive type 2 diabetics with nephropathy.     

Effects of Different Doses of Irbesartan Combined With Spironolactone on Urinary Albumin Excretion Rate in Elderly Patients With Early Type 2 Diabetic Nephropathy

Background

There is a lack of research on the effect of low dose of angiotensin receptor blockers combined with spironolactone, and the effect of high dose of angiotensin receptor blockers alone on the urinary albumin excretion rate (UAER) in elderly patients with early type 2 diabetic nephropathy (DN).

The Effects of Peg-Interleukin-2 and Interleukin-2 on Essential Hypertension and Cellular Immune Function in the Spontaneously Hypertensive Rat

The effects of recombinant human interleukin-2 covalently linked to polyethylene glycol (PEG-IL-2) or interleukin-2 (IL-2) on hypertension and in vitro suppressor T cell function in the spontaneously hypertensive rats (SHR) were investigated. Male young prehypertensive(4 weeks old) SHRs and adult (10 weeks old) SHRs with established hypertension were injected with low (5,000 units (u)/kg) or high (50,000-100,000 u/kg) dose of PEG-IL-2 or IL-2 as a single bolus or repeated injections. Systolic blood pressure was measured twice weekly using the tail-cuff technique. Systolic blood pressure in the PEG-IL-2 or IL-2 treated animals, irrespective of age, dose, or route of injection, did not differ significantly from that measured in vehicle-treated controls over a 10 week period. Mean arterial pressure measured by intra-arterial catheter was 159 ± 7 mm Hg 10 weeks after treatment with repeated injections of 5,000 u/kg of PEG-IL-2 and 158 ± 9 mm Hg in vehicle-treated controls. All rats injected with IL-2 had IL-2-specific IgG antibody in their sera. None of the PEG-IL-2 treated rats had any detectable anti-IL-2 antibodies in their sera. Thus, PEG-IL2 showed far less immunogenici than IL-2. Suppressor T (Ts) cells generated from adult SHR spleen cells failed to supress pokeweed mitogen (PWM)-driven immunoglobulin G (IgG) synthesis. PEG-2 or IL-2 supplementation both in vitra and in vivo restored the ability of adult SHR to enerate Ts cells able to inhibit IgG synthesis. Our data suggest that PEG-IL-2 or IL-2 administration does correct a rominent defective Ts cell activity found in adult SHR, but that correction or this immune abnormality is not attended by an attenuation of hypertension.     

The N-acetyltransferase (NAT) Gene: An Early Risk Marker for Diabetic Nephropathy in Japanese Type 2 Diabetic Patients?

A point mutation in the N-acetyltransferase gene (NAT2) leads to the recessive trait for the slow acetylator phenotype, which is suggested to be associated with microalbuminuria in Type 1 diabetic patients. Our study was designed to elucidate whether the NAT2 gene polymorphism would be a marker for diabetic nephropathy. The genotype distribution was studied in Japanese Type 2 diabetic patients with established nephropathy (n = 43), with microalbuminuria (n = 24), with normoalbuminuria (n = 18), non-diabetic patients with kidney disease (n = 62), and healthy control subjects (n = 51). The different alleles of the NAT2 gene were identified by restriction fragment length polymorphism analysis: the gene was amplified from genomic DNA (obtained from blood) and digested with restriction enzymes. The genotype was classified by the specific pattern of each allele (M1, M2, M3) in the agarose electrophoresis and ethdium bromide fluorescence. Alleles M1, M2, and M3 of NAT2 gene were found in 42.4% of all subjects (40.0% in all diabetic patients and 44.2% in all non-diabetic controls). The prevalence of the genotype, encoding the slow acetylator phenotype, was 7.0% in diabetic patients with established diabetic nephropathy, 20.8% in microalbuminuric diabetic patients, 0% in normoalbuminuric diabetic patients, 6.5% in non-diabetic patients with kidney disease, and 7.8% in healthy control subjects. The differences in the prevalence were non-significant. The results suggest that the N-acetyltransferase gene polymorphism may not be a genetic risk marker for diabetic nephropathy in Japanese Type 2 diabetic patients. Further studies with larger numbers of patients are required to confirm this observation.     

通心络胶囊治疗糖尿病肾病疗效观察

目的探讨通心络胶囊对糖尿病肾病的临床疗效。方法将2010年5月—2012年5月55例糖尿病肾病患者随机分为两组,治疗组30例,采用通心络胶囊合并基础治疗加减;对照组25例,给予替米沙坦。疗程均为3个月。3个月后检测尿微量白蛋白,空腹血糖及糖化血红蛋白,观察症状改变及药物不良反应。结果尿微量白蛋白改善方面试验组,总有效率80.0%。对照组总有效率64.0%。两组总有效率比较,差异有显著性意义（P〈0.05）,试验组疗效优于对照组。两组患者治疗后血糖及糖化血红蛋白均较治疗前有所改善,但无统计学意义（P〉0.05）。结论通心络胶囊可以有效降低糖尿病肾病患者尿微量白蛋白,降低空腹血糖及糖化血红蛋白,表明通心络有改善患者肾功能的作用,同时具有调节患者血糖水平的作用,且无明显毒副作用。