前列地爾合并腎康片對2型糖尿病腎病患者血清TNF—α、IL—6及IL—8水平的影響

邱冬豪　趙寧　王鳴

[摘要] 目的 研究前列地爾合并腎康片對2型糖尿病腎病患者血清腫瘤壞死因子-α（TNF-α）、白介素-6（IL-6）及白介素-8（IL-8）水平的影響。 方法 選取2014年6月～2015年5月我院收治的62例2型糖尿病腎病患者，根據隨機抽簽法分為試驗組與對照組，各31例。對照組使用20 mL的生理鹽水和10 μg的前列地爾混合后，靜脈推注的方式給藥，1次/d。試驗組在對照組治療的基礎上口服腎炎康復片，一次5片，一天3次。所有患者的治療療程均為4周。觀察治療前和治療4周后的空腹血糖（FBG）、糖化血紅蛋白（HbA1c）、TNF-α、IL-6及IL-8水平變化，評判兩組患者的不良反應。 結果 治療后，試驗組的TNF-α、IL-6及IL-8水平顯著低于對照組[（7.30±0.41）ng/L vs （9.44±1.78）ng/L，（9.39±0.31）ng/L vs （11.36±0.66）ng/L，（7.25±0.95）ng/L vs （11.35±1.07）ng/L]（P<0.05）。試驗組的FBG、HbA1c水平顯著低于對照組[（6.52±0.40）mmol/L vs （9.32±0.64）mmol/L，（6.53±0.60）% vs （7.44±0.68）%]（P<0.05）。試驗組和對照組的不良反應率比較差異無統計學意義[12.90%（4/31） vs 16.13%（5/31）]（P>0.05）。結論 前列地爾合并腎康片能明顯降低2型糖尿病腎病患者血清TNF-α、IL-6、IL-8、FBG、HbA1c水平，臨床療效良好，安全性高。

[關鍵詞] 前列地爾；腎康片；2型糖尿病腎病；TNF-α；IL-6；IL-8

[中圖分類號] R587.1 [文獻標識碼] A [文章編號] 1673-9701（2017）13-0034-04

[Abstract] Objective To explore the effects of alprostadil combined with Shenkang tablet on serum TNF-α， IL-6 and IL-8 levels in patients with type 2 diabetic nephropathy. Methods Sixty-two patients with type 2 diabetic nephropathy in our hospital from June 2014 to May 2015 were enrolled in the study. According to the randomized method， the patients were divided into experimental group（n=31） and control group（n=31）. The control group was treated with 20 mL of physiological saline and 10 μg of alprostadil intravenously once a day. The experimental group was given Shenkang tablets orally once five， three times a day based on the treatment of the control groups. All patients were treated for 4 weeks. The changes of fasting blood glucose （FBG）， glycosylated hemoglobin（HbA1c）， TNF-α， IL-6 and IL-8 levels before and 4 weeks after treatment were observed， and the adverse reactions of the two groups were evaluated. Results After treatment， the levels of TNF-α， IL-6 and IL-8 in the experimental group[（7.30±0.41） ng/L， （9.39±0.31）ng/L， 7.25±0.95）ng/L] were significantly lower than those in the control group [（9.44±1.78）ng/L， （11.36±0.66） ng/L， （11.35±1.07） ng/L）]（P<0.05）.The levels of FBG and HbA1c in the experimental group[（6.52±0.40） mmol/L， （6.53±0.60）%] were significantly lower than those in the control group[（9.32±0.64） mmol/L， （7.44±0.68）%] （P<0.05）. There was no significant difference in the adverse reaction rate between the experimental group and the control group[12.90%（4/31） vs 16.13% （5/31）] （P>0.05）. Conclusion Prostaglandil combined with Shenkang tablet can significantly reduce the levels of serum TNF-α， IL-6， IL-8， FBG and HbA1c in patients with type 2 diabetic nephropathy. The clinical efficacy is good and the safety is high.

[Key words] Alprostadil； Shenkang tablet； Type 2 diabetic nephropathy； TNF-α； IL-6； IL-8

2型糖尿病腎病屬于糖尿病較為常見的一種并發癥，也是導致糖尿病患者死亡的主要因素。在治療糖尿病腎病中降糖藥物的選取尤為關鍵，其所引發的低血糖等不良反應，有利于降低血糖水平[1]。前列地爾在改善微循環中具有較好的效果，但其曾使用粉針制劑常常伴有靜脈炎等不良反應，前列地爾在脂微球包裹后，能大幅度降低藥物所產生的不良反應，并且還能加強藥物在血管病變部位中的濃度[2-3]。為探討如何有效的治療2型糖尿病腎病，本研究就前列地爾合并腎康片對2型糖尿病腎病患者血清腫瘤壞死因子-α（Tumor necrosis factor alpha，TNF-α）、白介素-6（Interleukin-6，IL-6）及白介素-8（Interleukin-8，IL-8）和水平的影響進行分析，現報道如下。……