贝前列素钠对老年2型糖尿病肾病患者血浆血管内皮生长因子及内皮素-1的影响

目的观察贝前列素钠对老年2型糖尿病肾病（diabeticnephropathy，DN）患者的临床疗效，并观察患者血浆血管内皮生长因子（vascularendothelialgrowthfactor，VEGF）及内皮素-1（endothelin-1，ET-1）水平的变化。方法将48例老年2型糖尿病肾病患者按随机数字分类法分为常规治疗组和贝前列素钠治疗组2组，另外27例2型老年糖尿病无。肾病患者为对照组，测定各组治疗前后VEGF及ET-1水平的变化，探讨血浆VEGF及ET-1水平变化在糖尿病肾病发病中的可能作用。结果2型糖尿病肾病患者较2型糖尿病无肾病患者血浆VEGF及ET-1水平明显升高[VEGF为（4．68±0．97）pg／L，ET-1为（138±9）ng／L]（P〈0．01），差异有统计学意义，与常规治疗组比较应用贝前列素钠可使糖尿病肾病患者血浆VEGF及ET-1水平明显降低[VEGF为（2．82±0．14）pg／L，ET-1为（72±4）ng/L]（均P〈0．05），差异有统计学意义，尿白蛋白排泄率（urinaryal buminexcretionrates，UAER）明显降低[UAER（89±27）mg／24h]（P〈0．05），差异有统计学意义。结论VEGF及ET-1水平升高在糖尿病肾病的发病中发挥重要作用。贝前列素钠治疗可纠正糖尿病。肾病患者血浆VEGF和ET-1平衡失调，改善糖尿病肾病内皮功能，降低尿蛋白，对糖尿病肾病有保护作用。

Effects of beraprost sodium on plasma VEGF and ET-1 in elderly patients with type 2 diabetic nephropathy

Objective To observe the effect of beraprost sodium on elderly patients with type 2 diabetic nephropathy （DN） and to observe the change of the plasma vascular endothelial growth factor（VEGF） and endothelin（ ET-1 ） level. Methods The levels of plasma VEGF and ET-1 in the 27 cases of type 2 diabetes without nephropathy and 48 cases with type 2 diabetic nephropathy were measured. The possible role of VEGF and ET-1 in diabetic nephropathy was explored. 48 cases of type 2 diabetic nephropathy patients were randomly divided into 2 groups： the conventional treatment group and beraprost sodium treatment group. The changes of VEGF and ET-1 level in the 2 groups before and after the treatment were measured. Results The plasma VEGF and ET-1 levels were significantly higher in type 2 diabetic nephropathy patients than in type 2 diabetes patients without nephropathy（P 〈0.01 ）. Compared with the control group, beraprost sodium significantly reduced the plasma VEGF and ET-1 levels in patients with diabetic nephropathy （ P 〈 0. 05 ） , and also reduced urinary albumin excretion rates （UAER） significantly （P 〈 0. 05）. Conclusions The increasing level of VEGF and ET-1 plays an important role in the onset of diabetic nephropathy. Beraprost sodium can correct the balance of the plasma VEGF and ET-1 in treatment of patients with diabetic nephropathy, improves the endothelial function in diabetic nephropathy, decreases urine protein, and plays a protective role in diabetic nephropathy.