CAJ | 학술논문

目的：了解糖尿病肾病（DN）患者血清胱抑素C（Cys C）、色素上皮衍生因子（PEDF）、血管内皮生长因子（VEGF）水平及缬沙坦联合阿魏酸钠干预治疗的效果。方法选择153例糖尿病患者作为糖尿病组，根据尿清蛋白与肌酐的比率（ACR ）将其分为正常蛋白尿组、微量蛋白尿组和临床蛋白尿组，并选取30例同期门诊健康体检者作为对照组。微量蛋白尿组及临床蛋白尿组患者分别随机分为缬沙坦治疗组和缬沙坦联合阿魏酸钠治疗组，收集受试对象治疗前、后的血清及尿液标本。采用酶联免疫吸附测定（ELISA）法检测血清PEDF、VEGF水平，同时检测空腹血糖、糖化血红蛋白（GHbA1c）、血肌酐、尿素、Cys C。结果与健康对照组相比，正常蛋白尿组、微量蛋白尿组和临床蛋白尿组患者血清Cys C、PEDF、VEGF水平显著升高（P＜0．05），并随DN的进展而逐渐升高。缬沙坦联合阿魏酸钠治疗可显著减少蛋白尿，并降低患者血清Cys C、PEDF、VEGF水平（P＜0．05），提示缬沙坦联合阿魏酸钠可能通过改善糖尿病肾脏异常血管新生发挥肾脏保护效应，且联合用药效果优于缬沙坦单药治疗。结论 DN患者血清Cys C、PEDF、VEGF高表达，缬沙坦联合阿魏酸钠治疗效果显著。
목적：료해당뇨병신병（DN）환자혈청광억소C（Cys C）、색소상피연생인자（PEDF）、혈관내피생장인자（VEGF）수평급힐사탄연합아위산납간예치료적효과。방법선택153례당뇨병환자작위당뇨병조，근거뇨청단백여기항적비솔（ACR ）장기분위정상단백뇨조、미량단백뇨조화림상단백뇨조，병선취30례동기문진건강체검자작위대조조。미량단백뇨조급림상단백뇨조환자분별수궤분위힐사탄치료조화힐사탄연합아위산납치료조，수집수시대상치료전、후적혈청급뇨액표본。채용매련면역흡부측정（ELISA）법검측혈청PEDF、VEGF수평，동시검측공복혈당、당화혈홍단백（GHbA1c）、혈기항、뇨소、Cys C。결과여건강대조조상비，정상단백뇨조、미량단백뇨조화림상단백뇨조환자혈청Cys C、PEDF、VEGF수평현저승고（P＜0．05），병수DN적진전이축점승고。힐사탄연합아위산납치료가현저감소단백뇨，병강저환자혈청Cys C、PEDF、VEGF수평（P＜0．05），제시힐사탄연합아위산납가능통과개선당뇨병신장이상혈관신생발휘신장보호효응，차연합용약효과우우힐사탄단약치료。결론 DN환자혈청Cys C、PEDF、VEGF고표체，힐사탄연합아위산납치료효과현저。
Objective To explore the expression of serum Cys C,pigment epithelium-derived factor(PEDF),vascular endothelial growth factor(VEGF)and the effect of combined treatment with Valsartan and Sodium Ferulate in diabetic nephropathy(DN).Methods 153 cases of patients with diabetes were enrolled in the study as diabetes group,which were divided into normal albumi-nuria group,microalbuminuria group,and clinical proteinuria group,while 30 cases of healthy persons were recruited over the same period randomly as control group.Microalbuminuria group,and clinical proteinuria group were divided into Valsartan treatment group and Valsartan and Sodium Ferulate combined treatment group,respectively.serum and urine specimens were collected before and after treatment.Serum PEDF and VEGF were determined by ELISA,and glucose (GLU),glycosylated hemoglobin A1c (GHbA1c),creatinine(CREA),urea(UREA)and cystatin C(Cys C)were detected simultaneously.Results Compared with the healthy control group,normal albuminuria group,microalbuminuria group and clinical proteinuria group were with higher levels of serum Cys C,PEDF and VEGF (P<0.05),which gradually increased with the progress of DN.Valsartan combined with Sodium Ferulate treatment can significantly reduce proteinuria and reduced serum Cys C,PEDF,VEGF levels (P<0.05).Valsartan com-bined with Sodium Ferulate may improve abnormal angiogenesis in diabetic kidneys to protect renal function,and the effect of com-bination therapy is superior to Valsartan monotherapy.Conclusion The levels of serum Cys C,VEGF and PEDF were highly ex-pressed in diabetic nephropathy patients,predicting therapeutic effect significantly with drug combination of Valsartan and Sodium Ferulate.