YU Jiawei,FENG Bing,ZENG Wei,et al.Efficacy of ursodeoxycholic acid in treatment of early diabetic nephropathy: report of 40 cases[J].J Third Mil Med Univ,2018,40(20):1870-1875.

熊去氧胆酸对糖尿病肾病的疗效分析(/HTML )




Efficacy of ursodeoxycholic acid in treatment of early diabetic nephropathy: report of 40 cases
YU Jiawei FENG Bing ZENG Wei WEI Yi WANG Limin

Department of Nephrology, Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037; Department of Endocrinology, Henan Provincial People’s Hospital, Zhengzhou, Henan Province, 450042, China

ursodeoxycholic acid diabetic nephropathy urinary albumin/creatinine ratio estimated glomerular filtration rate inflammatory cytokine
R587.1; R692.39; R975.5

目的    观察熊去氧胆酸(ursodeoxycholic acid,UDCA)对糖尿病肾病(diabetic nephropathy,DN)Ⅲ期患者的疗效。方法    选择2016年5-12月在陆军军医大学第二附属医院肾内科诊断明确的DNⅢ期微量白蛋白尿期(Mogensen分期Ⅲ期)患者40例,年龄30~59岁,糖尿病病程6个月至30年,采用计算机随机分组方法将患者等分为2组:①厄贝沙坦组,患者口服厄贝沙坦片,0.15 g/d;②UDCA组,患者饭后口服UDCA胶囊,250 mg/d。治疗周期12个月。主要观察指标包括尿蛋白/肌酐值、血肌酐、肾小球滤过率(eGFR),以及血液炎症细胞因子表达变化。结果    至治疗期结束,厄贝沙坦组蛋白肌酐比值下降14.94%,血肌酐下降7.73%,eGFR增加8.64%,与治疗前比较,差异均有统计学意义(P<0.05);UDCA组蛋白/肌酐值下降10.39%,血肌酐下降6.49%,eGFR治疗前后增加7.41%,与治疗前比较,差异均有统计学意义(P<0.05)。两组间比较,各观察指标的差异无统计学意义(P>0.05)。与治疗前比较,厄贝沙坦组患者血浆中CRP、IL-6、TNF-α含量分别降低13.7%、8.7%、5.9%,差异均有统计学意义(P<0.05);与治疗前比较,UDCA组血浆中CRP、IL-6、TNF-α含量分别降低16.2%、14.1%、16.8%,差异均有统计学意义(P<0.05)。两组间比较,血浆中各个炎症细胞因子含量变化的差异无统计学意义(P>0.05)。结论     UDCA可以显著降低DN Ⅲ期患者的尿蛋白/肌酐值,保护肾功能,与厄贝沙坦疗效相当


ObjectiveTo observe the therapeutic effect of ursodeoxycholic acid (UDCA) for patients with early diabetic nephropathy (DN). MethodsFrom May 2016 to December 2016, a total of 40 patients with early DN (Mogensen stage Ⅲ) were diagnosed in the Nephrology Department of Xinqiao Hospital,  aged 30 to 59 years, with the course of disease ranging from 6 months to 30 years, were randomized equally into aprovel group (0.15 g/d) and UDCA group (250 mg/d after meal). The levels of urinary microalbumin, urinary albumin/creatinine ratio, creatinine, and estimated glomerular filtration rate (eGFR), and the contents of inflammatory cytokines in blood and urine were measured or calculated before and in 12 months after treatment, and the results were compared between the 2 groups. ResultsAfter 12 months of treatment, the patients in the aprovel group had the urinary albumin/creatinine ratio reduced by 14.94% and creatinine level by 7.73%, while eGFR increased by 8.64%, and significant differences were noted when compared with the values before treatment (P<0.05). Similar changes were also observed in the UDCA group (10.39%, 6.49% and 7.41%, respectively, P<0.05). But there were no significant differences in above indicators between the 2 groups (P>0.05). Aprovel treatment significantly decreased the serum levels of CRP, IL-6 and TNF-α by 13.7%, 8.7% and 5.9%, respectively, and UDCA also obviously reduced the levels by 16.2%, 14.1% and 16.8%, respectively. But no significant differences were observed between the 2 groups (P>0.05). ConclusionUDCA could decrease the urinary albumin/creatinine ratio, protect renal function and exert similar effects in the patients with stage Ⅲ.


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更新日期/Last Update: 2018-11-01