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目的:观察α-硫辛酸治疗早期糖尿病肾病的疗效,并探讨相关机制。方法:103例2型糖尿病早期肾病患者随机分为对照组(59例)和治疗组(44例),对照组采用饮食、运动、降糖等治疗控制血糖,治疗组在此基础上加用α-硫辛酸450 mg加入0.9%氯化钠注射液250 ml,ivd,qd。治疗10 d后,检测两组的糖化血红蛋白、血脂、血压、尿白蛋白、单核细胞趋化蛋白-1(MCP-1)和8-羟基脱氧鸟苷水平(8-OHdG)的变化。结果:与对照组相比,在血糖、血脂、血压水平控制相当的情况下,治疗组的尿白蛋白、MCP-1和8-OHdG水平明显下降(P<0.05),而在治疗前后,组内间的各项指标无明显改变。结论:α-硫辛酸可减少早期糖尿病尿白蛋白水平,其机制可能与其降低氧化应激及其下游MCP-1所致。
Objective: To observe the efficacy of α-lipoic acid in the treatment of early diabetic nephropathy and to explore the related mechanisms. Methods: One hundred and three patients with type 2 diabetes mellitus with early nephropathy were randomly divided into control group (n = 59) and treatment group (n = 44). The control group was treated with diet, exercise and hypoglycemic therapy to control blood sugar. - Alpha lipoic acid 450 mg 0.9% sodium chloride injection 250 ml, ivd, qd. After 10 days of treatment, the changes of glycosylated hemoglobin, blood lipid, blood pressure, urinary albumin, monocyte chemoattractant protein-1 (MCP-1) and 8-hydroxydeoxyguanosine (8-OHdG) were detected in both groups. Results: Compared with the control group, the levels of urinary albumin, MCP-1 and 8-OHdG in the treatment group decreased significantly (P <0.05) under the control of blood glucose, blood lipid and blood pressure, Within the various indicators no significant change. CONCLUSION: Alpha-lipoic acid can reduce the urinary albumin level in early stage diabetes mellitus, which may be related to the decrease of oxidative stress and its downstream MCP-1.