小剂量螺内酯对糖尿病肾病患者可溶性血管间黏附因子-1的影响

目的探讨螺内酯对2型糖尿病肾病（DN）患者可溶性血管间黏附因子-1（sVCAM-1）的影响。方法将2012年2月至2013年5月该院肾脏内分泌门诊及住院的94例2型糖尿病患者分为单纯糖尿病组（SDM组）30例、早期糖尿病肾病组（EDN组）32例、临床糖尿病肾病组（CDN组）32例。另选择34名健康者作为对照组。糖尿病组（SDM组、EDN组、CDN组）给予小剂量螺内酯治疗，采集治疗前和治疗12周后静脉血和24h尿。检测各组血清中sVCAM-1水平、尿微量清蛋白排泄率（UAER）等。结果治疗前，血清sVCAM—1水平在SDM组、EDN组及CDN组中均明显高于健康对照组，差异有统计学意义（P〈0．01）；螺内酯治疗12周后，三组患者血清sVCAM-1水平及UAER较治疗前降低，差异均有统计学意义（P〈0．05）。结论小剂量螺内酯能显著降低DN患者血清sVCAM-1水平及UAER，延缓DN的进展。

Effects of small doses of spironolactone on soluble vascular cell adhesion molecule-1 in patients with diabetic nephropathys

Objective To investigate the effects of spironolactone on soluble vascular cell adhesion molecule-1 （sVCAM-1） in patients with diabetic nephropathy （DN）. Methods 94 cases of type 2 diabetes mellitus （T2DM）, who hospitalized in depart merit of nephrology and endocrinology in the hospital from February 2012 to May 2013,were divided into 3 groups：simple diabetic mellitus group （SDM group, n=30）, early diabetic nephropathy group （EDN group, n=32） and clinical diabetic nephropathy group （CDN group, n=32） ;while 34 cases of healthy people were taken as control group. Diabetic groups （SDM group, EDN group and CDN group） were given a small dose of spironolactone, venous blood before treatment and 12 weeks after treatment and 24 h urine were collected, sVCAM-1, urinary albumin excretion rate （UAER） were detected in each group. Results Before treatment, the levels of sVCAM-I in SDM group,EDN group and CDN group were significantly higher than those in the control group with sta- tistically significant difference （P〈0.01） ;After 12-week treatment of spironolactone, the level of sVCAM-1 and UAER in the three groups w,＇re all reduced, and the difference was statistically significant （P〈0.05）. Conclusion Small dose of spironolactone can reduce the lcvel of serum sVCAM-1 and UAER in patients with DN, and it can slow the progress of DN.