TNF-α对糖尿病早期肾病影响的临床研究

目的探讨厄贝沙坦对早期糖尿病肾病肿瘤坏死因子-α（TNF-α）的影响。方法将早期糖尿病肾病患者46例分为A组、B组;两组均予常规降糖治疗,A组在常规治疗基础上加用药物厄贝沙坦治疗,疗程12周,同时设健康对照组。观察A、B两组治疗前后血清TNF-α、糖化血红蛋白、空腹血糖、谷丙转氨酶、尿素氮、肌酐、肾脏彩色多普勒血流情况、HOMA2-IR;同时记录治疗过程中尿白蛋白排出量（UAE）和平均动脉压（MAP）情况。观测健康参照组以上参数（检查只做一次）。结果早期糖尿病肾病患者TNF-α水平均高于健康参照组（P〈0.01）,厄贝沙坦治疗A组后TNF-α水平比B组低（P〈0.05）。结论降低血清TNF-α水平可能是厄贝沙坦治疗早期糖尿病肾病机制之一。

Clinical Research on Effect of Tumor Necrosis Factor-A in Diabetes Patients with Early Diabetic Nephropathy

Objective To investigate the effect of Irbesartan on tumor necrosis factor alpha（TNF-α） in diabetes patients with early diabetic nephropathy（DN）. Methods 46 cases with early DN were randomly divided into group A and B. Both groups were treated with regular methods to control blood glucose. Group A was administrated with Irbesartan additionally. The course of treat- ment was 12 weeks. The normal individuals were synchronously selected as control group. The serum TNF-α, HbA1 c, FBG, ALT, BUN,Cr,renal color Doppler flow situation, HOMA2-IR UAE and MAP of the three groups were recorded before and after the treatment. Results The level of serum TNF-α in early DN patients was higher than that of the control group （ P 〈 0.01 ）. The level of serum TNF-α in group A was lower than that of group B （P 〈 0.05）. Conclusion Lowering serum levels of TNF-α may be one of the treatment mechanisms of Irbesartan on early DN.