血清TGF—β1、CⅣ水平在糖尿病肾病早期中的变化及其受辛伐他汀的影响

目的探讨早期糖尿病肾病（DN）患者血清转化生长因子β1（TGF-β1）、Ⅳ型胶原（CⅣ）水平的变化及其受辛伐他汀干预的反应。方法88例2型糖尿病患者，根据尿白蛋白排泄率（UAER）分为糖尿病无肾病组（DM组）40例和早期糖尿病肾病组（早期DN组）48例。早期DN组又分为2个亚组，常规治疗组24例和辛伐他汀治疗组24例。采用EuSA法测定患者血清TGF-β1、CⅣ水平，采用放射免疫法检测24h尿白蛋白排泄率（UAER）。结果与糖尿病无肾病组比较，早期DN组患者血中TGF-β1、CⅣ水平有明显升高（均P〈0．05），且与UAER呈明显正相关（P〈0．05），TGF-β1与CⅣ呈明显正相关（P〈0．05）。与常规治疗组比较，辛伐他汀组治疗后血中TGF-β1、CⅣ水平及UAER明显降低（P〈0．05）。结论血清TGF-β1、CⅣ水平在早期DN中显著升高，辛伐他汀能降低其血清TGF-β1、CⅣ水平，改善肾功能。

Determination and Intervention with Simvastatin of Serum Transforming Growth Factor β1、Ⅳ Collagens Levels in Early Diabetic Nephropathy

Objective To determine the serum levels of transforming growth factorβ1(TGF-β1)、 Ⅳ collagens(CⅣ) in early diabetic nephropathy and their intervention with simvastatin.Methods 88 type 2 diabetes patients were divided into two groups according to the level of urinary album in excretion rate(UAER),40 were diabetic patients without nephropathy(group DM) and 48 were patients with diabetic nephropathy(groupDN).48 patients of group DN were randomly divided into ruoutine group and simvastatin group.The levels of TGFβ1 and Ⅳcollagens were detected with ELISA,the 24-hour urinary album in excretion rate(UAER) were evaluated with radio-active immunoassay.Results Compared with DM patients,early DN patients showed significantly higher serum levels of TGF-β1、CⅣ(P<0.05),which positively correlated with UAER(P<0.05).Therapy with simvastatin resulted in significant reduction of serum TGF-β1 、CⅣ levels and UAER(P<0.05).Conclusion Levels of TGF-β1 、CⅣ are elevated in early DN patients;simvastatin can decrease the levels of TGF-β1 、CⅣ and show it' protective effects on early diabetic nephropathy.