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目的:观察罗格列酮治疗糖尿病肾病前后血清C反应蛋白(CRP)的变化及其影响因素,探讨炎症因子与糖尿病肾病的关系。方法:将56例2型糖尿病肾病受试者随机分为罗格列酮治疗组(RSG组)和卡托普利治疗组(ACEI组),分别应用RSG(4 mg/d)及卡托普利(25~50 mg/d)治疗12周,观察治疗前后C反应蛋白水平的变化。结果:1.罗格列酮治疗前后CRP(6.81±1.73 mg/L vs 2.46±0.65 mg/L;P<0.05)差异有统计学意义。2.RSG组CRP(2.46±0.65 mg/L vs 3.96±1.00 mg/L;P<0.05)及UAlb/Cre(28.22±1.65μg/mg vs 37.83±2.73μg/mg;P<0.05)的改善明显优于对照组。3.RSG组CRP与FPG、2hPG、空腹C肽、HbA1C、UAlb/Cre均有正相关关系(P<0.01)。结论:罗格列酮治疗早期糖尿病肾病在降低炎症反应以致最终减少尿微量蛋白方面可能优于卡托普利。
Objective: To observe the changes of serum C-reactive protein (CRP) and its influencing factors before and after treatment of diabetic nephropathy with rosiglitazone and explore the relationship between inflammatory cytokines and diabetic nephropathy. Methods: Fifty-six patients with type 2 diabetic nephropathy were randomly divided into rosiglitazone treatment group (RSG group) and captopril treatment group (ACEI group). RSG (4 mg / d) and captopril Lee (25 ~ 50 mg / d) for 12 weeks to observe changes in C-reactive protein levels before and after treatment. Results: 1.The difference of CRP (6.81 ± 1.73 mg / L vs 2.46 ± 0.65 mg / L; P <0.05) before and after rosiglitazone treatment was statistically significant. The CRP of 2.46 ± 0.65 mg / L vs 3.96 ± 1.00 mg / L in RSG group and 28.22 ± 1.65 μg / mg of UAlb / Cre (37.83 ± 2.73 μg / mg; P <0.05) were significantly improved Better than the control group. There was a positive correlation between CRP and FPG, 2hPG, fasting C-peptide, HbA1C and UAlb / Cre in RSG group (P <0.01). CONCLUSIONS: Rosiglitazone may be superior to captopril in the treatment of early diabetic nephropathy in reducing the inflammatory response and eventually reducing urinary microalbumin.