CAJ | 학술논문

目的：探讨缬沙坦对早期糖尿病肾病患者血清转化生长因子-β1（ TGF-β1）、D-二聚体（ D-D）及胱抑素C（ CysC）水平的影响。方法：30例体检健康者作为对照组（ NC组），90例合并糖尿病肾病的2型糖尿病患者分为正常白蛋白尿1组（ NA1组， UMA／Cr＜10μg／mg）22例，正常白蛋白尿2组（NA2组，UMA／Cr 10～30μg／mg）29例，微量白蛋白尿组（MA组，UMA／Cr 31～300μg／mg）39例，均合并DR、高血压，应用缬沙坦80mg／d共4周。分别采血测定用药前后血清TGF-β1、D-D及CysC水平。结果：NA1组、NA2组、MA组血清TGF-β1、D-D、CysC水平明显升高（P＜0.05），且3组间比较差异也均有统计学意义（P＜0.05）。DN各组中应用缬沙坦后血清TGF-β1、D-D及CysC水平明显下降（ P＜0.05）。结论：血清TGF-β1、D-D及CysC有可能作为早期糖尿病肾病的特异性指标。早期应用缬沙坦可能通过降低DN患者血清TGF-β1、D-D及CysC的水平延缓DN的发生、发展。
목적：탐토힐사탄대조기당뇨병신병환자혈청전화생장인자-β1（ TGF-β1）、D-이취체（ D-D）급광억소C（ CysC）수평적영향。방법：30례체검건강자작위대조조（ NC조），90례합병당뇨병신병적2형당뇨병환자분위정상백단백뇨1조（ NA1조， UMA／Cr＜10μg／mg）22례，정상백단백뇨2조（NA2조，UMA／Cr 10～30μg／mg）29례，미량백단백뇨조（MA조，UMA／Cr 31～300μg／mg）39례，균합병DR、고혈압，응용힐사탄80mg／d공4주。분별채혈측정용약전후혈청TGF-β1、D-D급CysC수평。결과：NA1조、NA2조、MA조혈청TGF-β1、D-D、CysC수평명현승고（P＜0.05），차3조간비교차이야균유통계학의의（P＜0.05）。DN각조중응용힐사탄후혈청TGF-β1、D-D급CysC수평명현하강（ P＜0.05）。결론：혈청TGF-β1、D-D급CysC유가능작위조기당뇨병신병적특이성지표。조기응용힐사탄가능통과강저DN환자혈청TGF-β1、D-D급CysC적수평연완DN적발생、발전。
Objective:To investigate the relationship between serum transforming growth factor-β1(TGF-β1), D-Dimer(D-D), cys-tatinC(CysC) levels and early and early diabetic nephropathy and clarify whether valsartan plays a role in renal protection by reducing the level of serum TGF-β1, D-D, CysC.Methods:The study subjects were divided into 4 groups:control group (30 cases);normal albumi-nuria group 1( NA1 group with 22 cases, UMA /Cr <10 μg/mg combined with type 2 diabetes) ;normal alb-uminuria grop 2 ( NA2 group with 29 cases, UMA/Cr10~30μg/mg combined with type 2 diabetes);mieroalbuminuria group ( MA group with 39 cases, UMA/Cr31~300 μg/mg combined with type 2 diabetes).All these type 2 diabetic patients were suffering from diabetic refinopathy and hyper-tension.Valsartan (80 mg/d) were medicated for patients.The serum TGF-β1, D-D, CysC levels were measured in all subjects before and after treatment.Results:Serum TGF-β1, D-D, CysC levels in 3 diabetes groups were higher than those in control group(P<0.05). There were significant differences in serum TGF-β1, D-D, CysC levels among MA group, NA 2 group and NA1 group (P<0.05). Serum TGF-β1, D-D, CysC levels in NA1 group with valsartan treatment significantly decreased compared with those before treatment ( P<0.05).Conlusion:High serum TGF-β1, D-D, CysC level may be associated with type 2 diabetes and early diabetic nephropathy. Valsartan may be delay the onset and development of early diabetic nephropathy by decreasing the serum TGF-β1, D-D, CysC level.