雷帕霉素联合坎地沙坦治疗2型糖尿病肾病的疗效观察

发布时间：2018-01-03 20:32

本文关键词：雷帕霉素联合坎地沙坦治疗2型糖尿病肾病的疗效观察　出处：《安徽医科大学学报》2015年06期 　论文类型：期刊论文

【摘要】：目的观察mT OR抑制剂(雷帕霉素)联合血管紧张素Ⅱ受体阻滞剂(坎地沙坦)对糖尿病肾病的作用。方法24只2型糖尿病模型db/db小鼠随机均等分为糖尿病组(D组)、雷帕霉素治疗组(R组)、坎地沙坦治疗组(C组)、雷帕霉素+坎地沙坦治疗组(R+C组);同时6只db/+小鼠作为阴性对照组(ND组)。治疗16周后,观察各组小鼠体重、血糖、血肌酐水平、尿白蛋白排泄率及肾组织病理指标的差异。结果与D组比较,雷帕霉素、坎地沙坦及两者联合治疗均可显著延缓db/db小鼠体重增长,差异有统计学意义(P0.01)。治疗16周后,R组、C组24 h尿白蛋白排泄率、血肌酐水平均低于D组,R+C组低于R组和C组,差异有统计学意义(P0.05)。与ND组比较,糖尿病各组肾小球体积、系膜区基质显著增加,雷帕霉素、坎地沙坦及两者联合治疗均可显著延缓肾小球体积增大及系膜基质增加;与R组、C组比较,R+C组肾小球体积及系膜区基质占肾小球面积百分比均明显降低,差异有统计学意义(P0.05)。电镜结果显示D组肾小球基底膜出现弥漫性或节段性增厚,雷帕霉素、坎地沙坦及两者联合治疗均可显著延缓肾小球基底膜增厚。结论雷帕霉素联合坎地沙坦可进一步降低尿白蛋白排泄率及血肌酐水平,延缓肾小球体积增大及系膜区基质沉积;在减轻糖尿病肾损害、延缓糖尿病肾病进展方面具有协同作用。
[Abstract]:Objective To observe the effects of mT inhibitor OR (rapamycin) combined with angiotensin II receptor blocker (candesartan) on diabetic nephropathy. Methods 24 rats model of type 2 diabetes db/db mice were randomly divided into diabetic group (D group), rapamycin treatment group (R group), candesartan treatment group (group C). Rapamycin plus candesartan treatment group (R+C group); and 6 db/+ mice were used as negative control group (ND group). After 16 weeks of treatment, observation of mice weight, blood glucose, serum creatinine, albumin excretion rate between pathological index and renal tissue of urine. Results compared with D group, rapamycin, candesartan combined treatment of losartan and db/db both significantly delayed the growth of mouse weight, the difference was statistically significant (P0.01). After 16 weeks of treatment, R group, C group, 24 h urinary albumin excretion rate, serum creatinine levels were lower than the D group, R+C group was lower than that of R group and C group, the difference was statistically significant (P0.05). ND group Compared diabetic glomerular volume, mesangial matrix increased significantly, rapamycin, candesartan combined treatment of losartan and both delayed significantly increased glomerular volume and mesangial matrix increased; with the R group, C group, R+C group of mesangial matrix and glomerular volume percentage of glomerular area decreased significantly, there was statistical significant differences (P0.05). The results of SEM showed that D group glomerular basement membrane showed diffuse or segmental thickening, rapamycin, candesartan combined treatment of losartan and both can significantly retard the development of glomerular basement membrane thickening. Conclusion rapamycin combined with candesartan can further reduce the urinary albumin excretion rate and serum creatinine, glomerular volume increased delay matrix and mesangial deposition; reduce diabetic kidney damage, has a synergistic effect to delay the progress of diabetic nephropathy.

【作者单位】：安徽医科大学第二附属医院肾脏内科;
【基金】：安徽高校省级自然科学基金重点项目(编号:KJ2010A168)
【分类号】：R587.2;R692.9
【正文快照】： 苏超,王德光,张桂霞,王瑞峰,袁亮,张晶晶,王雪荣,何衡杰,刘桂凌,郝丽帕霉素、坎地沙坦及两者联合治疗均可显著延缓肾小球基底膜增厚。结论雷帕霉素联合坎地沙坦可进一步降低尿白蛋白排泄率及血肌酐水平,延缓肾小球体积增大及系膜区基质沉积;在减轻糖尿病肾损害、延缓糖尿病肾

【共引文献】