葡糖胺聚糖对糖尿病肾病UAER、胰岛素抵抗和CRP的影响

目的探讨葡糖胺聚糖(GAGs)早期糖尿病肾病(DN)作用。方法60例2型糖尿病肾病患者,24 h尿白蛋白排泄率(UAER)30~300 mg。随机分为常规组(R组)、氯沙坦钾组(C组)、GAGs组(G组)。检测指标包括UAER、胰岛素抵抗(IR)指数(IRI)、C反应蛋白(CRP)、凝血三项、血脂、血糖、C肽、肝肾功能等。结果1.凝血三项:三组组内治疗前后各自比较,G组,差异显著(P<0.01);R组和C组,差异不显著(P>0.05);G组分别与R组和C组两组治疗后比较,差异显著(P<0.01)。2.CRP、UAER、IRI:三组组内治疗前后各自比较,G组和C组,差异显著(P<0.01);R组,差异不显著(P>0.05);G组分别与R组和C组两组治疗后比较,差异显著(P<0.01)。3.FBG、C肽-及HbA1 c:三组组内治疗前后各自比较,G组和C组,差异显著(P<0.01);R组,差异不显著(P>0.05)。4.三组血压、血脂、肝肾功各指标治疗前后比较,差异均不显著(P>0.05);G组与R组治疗后比较,差异显著(P<0.01);G组与C组治疗后比较,差异不显著(P>0.05)。结论GAGs能够减少微量白蛋白尿期DN患者的UAER,改善IR,降低血清CRP。对血压、血脂、肝肾功能无影响。

Glycosaminoglycans on CRP and UAER of early diabetic nephropathy

Objective To observe the therapeutic effect of glycosaminoglycans(GAGs) on diabetes mellitus(DM) with early nephropathy in order to find a new therapeutic approach to diabetic nephropathy(DN).Methods 60 cases of type 2 DN(albuminuria: 30 to 300 mg/24 h) without hypertension were randomly divided into routine group,cozaar(losartan potassium) group and GAGs group.Insulin resistant index(IRI),C reactive protein(CRP),urinary albumin excretion rate(UAER),blood clotting indexes and blood fat,blood glucose and C peptide and hepatic,kidney function were tested.Results After three months treatment,the levels of UAER were decreased significantly in both GAGs group and Cozaar group(P<0.01). During the three months UAER was lowering step by step,and there was no difference between them.The levels of UAER had no changes in regular group and there was significant difference from that in the former two groups.In GAGs group,the levels of whole blood viscosity of medium shear rate,whole blood viscosity of medium sheer rate,whole blood viscosity of low shear rate were declined significantly;that of plasma viscosity,whole blood reduced viscosity,CRP,IRI were all decreased to some degree.BUN,Cr,fasting serum C peptide and blood pressure etc had no change among three groups before and after observation.Conclusions GAGs has the therapeutic effect on type 2 DN patients with microalbuminuria because of its effect of decreasing UAER,CRP,IRI and it can postpone or reverse the development of DN.