目的 研究白芍总苷对糖尿病大鼠肾损伤的保护性作用及机制.方法 用高糖高脂饲养及腹腔注射链佐菌素的方法构建糖尿病大鼠模型,将建模成功的大鼠随机分为模型组(n=10)和低(n=10)、高剂量实验组(n=10),另选10只正常大鼠,腹腔注射10 mL·kg-1枸橼酸钠缓冲液作为对照组.低、高剂量实验组分别给予80 mg·kg-1·d-1和160 mg·kg-1·d-1白芍总苷,灌胃,对照组和模型组给予25 mL·kg-11％羧甲基纤维素钠溶液,灌胃,连续干预10 d.测量大鼠体重(BW),用全自动生化分析仪测量大鼠空腹血糖(FBG)、空腹胰岛素(FINS)、血清肌酸酐(Scr)和24 h尿微量白蛋白(mALB)水平;取各组大鼠肾上皮细胞,用细胞计数试剂盒-8(CCK-8)法测定细胞存活率;用原位末端转移酶标记技术(TUNEL)法检测细胞凋亡率;用蛋白质印迹(Western blot)法检测B淋巴细胞瘤-2(Bcl-2)、Bcl-2相关X蛋白(Bax)、微管相关蛋白1轻链3β(LC3B)、硫氧还蛋白相互作用蛋白(Thioredoxin-interacting protein,TXNIP)的表达.结果 对照组、模型组和低、高剂量实验组大鼠空腹体重分别为(379.32±60.36),(549.96±70.96),(496.12±74.07)和(480.56±61.73)g;FBG分别为(5.42±0.57),(19.30±1.84),(14.85±1.68)和(13.72±1.08)mmol·L-1;FINS分别为(18.66±1.52),(29.48±4.10),(26.21±3.92)和(21.26±3.65)mU·L-1;Scr分别为(25.75±3.63),(39.28±4.99),(30.70±3.43),(23.94±3.22)μmol·L-1;mALB分别为(89.71±7.98),(337.78±35.64),(205.01±25.11)和(173.37±26.90)μg;细胞存活率分别为(100.00±0.00)％,(53.64±4.23)％,(62.26±5.05)％,(69.21±3.75)％;细胞凋亡率分别为(8.55±0.92)％,(37.14±2.88)％,(33.33±4.03)％,(26.79±2.74)％.以上指标,模型组与对照组相比较,低、高剂量实验组与模型组相比较,差异均有统计学意义(均P<0.05).结论 白芍总苷能显著抑制肾小管上皮细胞凋亡,促进细胞增殖并诱导自噬减轻糖尿病大鼠肾损伤,其作用机制可能与下调TXNIP表达有关.

选取2018年1月至2020年6月于产科住院的妊娠期高血压伴蛋白尿患者95例为观察组,另选取同期妊娠期高血压无蛋白尿患者60例为对照组,采用酶联免疫吸附法检测两组孕妇空腹外周血中C反应蛋白(CRP)、肿瘤坏死因子α (TNF-α)和单核细胞趋化蛋白1(MCP-1),分析其与患者蛋白尿转归和妊娠结局的关系.结果 表明:观察组患者血清CRP、TNF-α、MCP-1、尿素氮(BUN)及肌酐(Scr)水平均高于对照组,估算肾小球滤过率(eGFR)水平低于对照组;受试者工作特征(ROC)分析显示,血清CRP、TNF-α、MCP-1联合筛查妊娠期蛋白尿患者AUC为0.891(95％ CI为0.841～0.940),均显著高于单一检测指标;重度患者CRP、MCP-1和24 h尿蛋白水平高于中度组和轻度组,中度组上述指标水平显著高于轻度组;蛋白尿转归和妊娠结局转归良好患者CRP、TNF-α、MCP-1水平均显著低于不良患者.这说明外周血CRP、TNF-α、MCP-1水平的变化,对妊娠期高血压伴蛋白尿患者的筛查及转归评估具有重要意义.

Objective To investigate the difference of efficacy between Shengxuening and polysaccharide iron complex capsule in treating renal anemia in patients with hemodialysis. Methods A total of 50 cases of hemodialysis patients with renal anemia, who underwent hemodialysis regularly in blood purification center of Hefei Fifth People’s Hospital, were selected and randomly divided into observation group and control group, with 25 cases in each group. The treatment group was given Shengxuening tablets combined with erythropoietin and the control group given polysaccharide iron complex capsule combined with erythropoietin, with a treatment course of 12 weeks. Hemoglobin(Hb), hematocrit(Hct), serum ferritin(SF), and transferrin saturation(TSAT) were detected before treatment and at 4 weeks, 8 weeks and 12 weeks of the treatment.Results After 12 weeks, the indices were compared between the control treatment and the treatment group. Serum Hb, Hct, SF and TAST all increased significantly(P<0.05). The changes of the indices were more obvious. Compared to the control group, serum Hb, Hct, SF and TAST in the treatment group had statistically significant changes after treatment(P<0.05). Conclusions Shengxuening tablets can significantly improve hemoglobin, hematocrit, SF and TSAT in hemodialysis patients, promote iron absorption and utilization, increase iron storage in the body, and reduce iron consumption. Its efficacy for treatment of treating renal anemia in hemodialysis patients by combing with erythropoietin is more evident than polysaccharide iron complex capsule combined with erythropoietin.

目的:观察培哚普利联合尿毒清颗粒对早期糖尿病肾病疗效.方法:入选57例患者随机分为对照组28例及治疗组29例,对照组给予培哚普利4mg每日1次口服;治疗组在培哚普利4mg每日1次口服基础上,加用尿毒清颗粒每日4次,其中6,12,18时各服1袋(5g),22时(睡前)服2袋.用药间隔不超过8h.2组均以12周为1个疗程.观察治疗前及治疗后4、8、12周尿微量白蛋白排泄率(UAER),空腹血糖(FPG),血清总胆固醇(Tc),血清甘油三酯(TG),血清胱抑素-C(Cys-C)的变化.结果:2组UAER水平均随着治疗时间延长而不断降低,治疗后12周为最低,且治疗组明显低于对照组(P＜0.05).治疗后2组FPG、TC、TG、Cys-C水平均显著降低,治疗组降低程度较对照组更显著(P＜0.05).结论:培哚普利联合尿毒清颗粒治疗DN可以有效降低尿微量白蛋白排泄率,改善血糖、血脂水平,降低胱抑素-C水平.二者联用具有协同保护肾脏、辅助降糖降脂作用.