摘要
目的探讨2型糖尿病肾病患者尿转化生长因子(TGF)β1的状况及氯沙坦对抗纤维化的影响。方法检测33例2型糖尿病肾病患者氯沙坦(50mg/d×8周)治疗前后24小时尿蛋白、尿肌酐,尿TGFβ1和肌酐水平。尿TGFβ1的检测用ELISA法。20例健康志愿者的尿液标本作为对照组。结果与对照组比较,患者尿TGFβ1明显升高,随肾小球滤过功能损害的加重,尿TGFβ1排出增加,治疗前、治疗后尿TGFβ1浓度明显下降(P<0.001)。尿TGFβ1浓度变化与尿蛋白变化具有相关性(P<0.01)。结论随肾功能损害的加重,2型糖尿病肾病患者肾脏纤维化加重,氯沙坦通过降低2型糖尿病肾病患者TGFβ1水平发挥抗肾脏纤维化作用,尿TGFβ1减少可能是病情缓解的早期表现,这一表现可先于蛋白尿的变化。
Objective To observe the situation of urinary TGFβ1 excretion and the antifibrosis effect of Losartan in Type 2 diabetic nephropathy （DN） patients.Methods 33 type 2 DN patients were recruited. 24-hour fresh urine samples of patients were collected to measure urinary protein,creatinine excretion and urinary TGFβ1 excretion before and after treatment.Urinary TGFβ1 was determined by ELISA assay.Urine samples of 20 volunteers were measured as controls.Results Compared with the control group,the total Urinary TGFβ1 excretion was significantly increased（P〈0.01）.The excretion of urinary TGFβ1 increased with the aggravation of glomerular filtration.The TGFβ1 levels decreased obviously after administration of Losartan.Correlation between urinary TGF-β1 levels and proteinuria was found significantly （P〈0.01）.Conclusions Renal fibrosis of type 2 DN patients is aggravated with the damage of renal function.Losartan has a significant antifibrosis effect on DN patients through the reduction of urinary TGF-β1 excretion.We speculate that the reduction of urinary TGFβ1 excretion may be an earlier event of remission of kidney disease than the alteration of proteinuria
出处
《临床内科杂志》
CAS
2008年第3期190-192,共3页
Journal of Clinical Internal Medicine
