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目的观察硫辛酸对早期糖尿病肾病患者尿微量白蛋白和炎症的影响,探讨其治疗早期糖尿病肾病的机制。方法选取60例早期2型糖尿病肾病患者,随机分为对照组30例,治疗组30例,对照组给予常规治疗,治疗组在常规治疗基础上加用硫辛酸治疗,均治疗14 d,另选择健康对照组30例。观察治疗前后患者24 h尿微量白蛋白排泄率(UAER)、血清肌酐(SCr)、空腹血糖、餐后血糖、血清高敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)水平的变化。结果与健康对照组比较,早期2型糖尿病肾病患者血清hs-CRP、TNF-α水平明显升高(P<0.01),治疗组经硫辛酸治疗后与治疗前及对照组治疗后比较,其hs-CRP、TNF-α、SCr、UAER水平明显降低(P<0.05)。结论硫辛酸通过改善早期2型糖尿病肾病炎症状态,减少尿微量白蛋白排泄和降低血肌酐水平,从而达到肾脏保护作用。
Objective To observe the effect of lipoic acid on urinary albumin and inflammation in patients with early diabetic nephropathy and to explore its mechanism of treatment of early diabetic nephropathy. Methods Sixty patients with early type 2 diabetic nephropathy were randomly divided into control group (n = 30), treatment group (n = 30) and control group (n = 30). The treatment group was treated with lipoic acid on the basis of routine treatment, Healthy control group of 30 cases. The levels of urinary albumin excretion (UAER), serum creatinine (SCr), fasting blood glucose, postprandial blood glucose, serum hs-CRP, TNF-α The change. Results Compared with the healthy control group, the serum hs-CRP and TNF-α levels in patients with early stage type 2 diabetic nephropathy were significantly increased (P <0.01). After treatment with lipoic acid in the treatment group and before treatment and in the control group, the hs -CRP, TNF-α, SCr, UAER levels were significantly lower (P <0.05). Conclusion Lipoic acid can protect the kidneys by improving the inflammatory state of early type 2 diabetic nephropathy, reducing urinary albumin excretion and lowering serum creatinine.