辛伐他汀对2型糖尿病肾病患者足细胞损伤修复的影响

目的 探讨辛伐他汀对糖尿病肾病患者足细胞损伤的保护及修复作用.方法 将89名糖尿病肾病患者随机分为对照组及辛伐他汀治疗组（实验组）.检测各组患者在入组时及3个月后血糖、糖化血红蛋白（HbA1c）、血胆固醇、甘油三酯、血肌酐、尿素氮、尿白蛋白、Podocalyxin（PCX）等指标的变化,并采用尿足细胞特异性标记蛋白Podocalyxin （PCX） ELISA试剂盒对糖尿病肾病患者首次尿标本进行检测;同时,采用抗人足细胞标记蛋白Podocalyxin （PCX）抗体进行间接免疫荧光染色,对尿沉渣中足细胞进行检测.结果 实验组应用辛伐他汀治疗3个月,患者的总胆固醇、甘油三酯及尿podocalyxin水平及24 h尿蛋白定量水平较对照组均显著降低（P＜0.01或＜0.05）.结论 在糖尿病肾病早期即出现肾小球足细胞的损伤,随着病情的逐渐加重,这种变化愈发明显.足细胞病变不仅导致了大量蛋白尿的出现,而且还与肾小球硬化和肾功能损伤的发生有关.辛伐他汀对糖尿病肾病肾脏具有一定的保护作用.

Influence of Simvastatins on Renovating Podocytes Injuryed of Diabetic Nephropathy

Objective To investigate the protection and renovation against podocyte injury by simvastatin in diabetic nephropathy（DN） patients. Methods 89 DN patients were divided randomly into 2 groups ：Condi- tional Control Group and Experimental Group （simvastatin- treated group）. Plasma glucose, HbAlc, serum cholesterol, triglyceride, serum creatinine, blood uria nitrogen , urinary albumin and PCX were observed respec- tively at the group and 3 months of treatment . Urinary samples voided in the morning were obtained from 89 DN patients , which was examined by immunofluorescence, The podocytes were identified by immunofluo- rescence staining by using monoclonal antibody against human podocalyxin （PCX） presenting on the surface of podocytes. And urinary PCX content of the first morning urine was quantified by enzyme - linked immunosor- bent assay（ELISA） . And Urinary podocytes were identified by immunofluorescent staining of podocyte specific protein Podocalyxin（PCX）. The state of podocytes in glomeruli was observed using immunofluorescence. Finally, SPSS 13.0 software was used to analyze the data. Results At the 3 months, serum cholesterol, triglyceride, cre- atinine and PCX level, and urinary albumin excretion in experimental grou were significantly lower than those in conditional control group（P 〈 0.01 or 〈 0.05） . Conclusion Simvastatin has some renal protective effects on diabetic nephropathy patients, the injury of glomerular podocyte was observed in the early stage of patients with diabetic nephropathy and become more dramatic during the course of disease progression. The podocyte lesion not only associated with the degree of proteinuria, but also correlated with the development of glomerulosclerosis and renal function damage.