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中国临床药理学与治疗学 ›› 2008, Vol. 13 ›› Issue (3): 332-335.

• 药物治疗学 • 上一篇    下一篇

血管紧张素Ⅱ阻断剂治疗慢性肾小球肾炎时TNF-α和蛋白尿的相关性研究

张道友, 杨沿浪, 杨利才, 徐海红, 汪裕伟   

  1. 皖南医学院弋矶山医院肾内科, 芜湖241001, 安徽
  • 收稿日期:2007-05-28 修回日期:2007-05-28 发布日期:2020-10-15
  • 基金资助:
    安徽省学术和技术带头人科学研究基金资助项目(2002HBL25)

Clinical investigation of the correlation between TNF-αand proteinuria in patients with chronic glomerulonephritis treated with angiotensin Ⅱ blockers

ZHANG Dao-you, YANG Yan-lang, YANG Li-cai, XU Hai-hong, WANG Yu-wei   

  1. Department of Nephrology, Yijishan Hospital, Wannan Medical College, Wuhu 241001, Anhui, China
  • Received:2007-05-28 Revised:2007-05-28 Published:2020-10-15

摘要: 目的 探讨血管紧张素Ⅱ(Ang Ⅱ) 阻断剂对慢性肾小球肾炎(CGN) 患者肿瘤坏死因子-α(TNF-α) 的影响及TNF-α与蛋白尿之间的关系。 方法 32 例经肾穿刺活检证实为原发性CGN 并伴有明显蛋白尿患者, 分别接受Ang Ⅱ阻断剂[ 苯那普利、缬沙坦或两药联合(苯那普利+缬沙坦) ] 治疗, 疗程8 ~ 12 周。分别检测治疗前、后血TNF-α、尿TNF-α、24 小时尿蛋白定量和血肌酐水平, 并观察血、尿TNF-α水平与蛋白尿之间的关系。 结果 治疗后患者血、尿TNF-α水平、24 小时尿蛋白量较治疗前显著下降, 分别为(7.8 ±3.9) vs (5.0 ±1.6) fmol mL, (11.9 ± 6.8) vs (8.3 ± 3.5)fmol /mL, (2.55 ±2.01) vs (0.97 ±0.52) g(分别为P <0.01, P <0.05, P <0.01) 。治疗前后血TNF-α水平和24 小时尿蛋白排泄量均呈正相关(分别为r =0.515, P <0.01;r =0.385, P <0.05) 。治疗前后尿TNF-α与24 小时尿蛋白也均呈正相关(分别为r =0.622, P <0.05;r =0.360, P <0.05) 。 结论 CGN 患者血、尿TNF-α水平升高, 与尿蛋白水平呈正相关, Ang Ⅱ阻断剂可有效降低血、尿TNF-α的水平, 减少蛋白尿及保护肾功能。

关键词: 慢性肾小球肾炎, 肿瘤坏死因子-α, 蛋白尿, 血管紧张素Ⅱ

Abstract: AIM: To investigate the effects of angiotensin Ⅱ(Ang Ⅱ) blockers on TNF-αand the relationship between TNF-αand proteinuria in patients with chronic glomerulonephritis (CGN). METHODS: 32 patients examined by biopsy as primary CGN with proteinuria were treated by benazepril, valsartan or combination with benazepril and valsartan for 8 to 12 weeks respectively.The TNF-αlevels in serum and urine, 24 hours proteinuria quantity, and serum creatinine level were assayed and recorded respectively before and after 8 to 12 weeks therapy. RESULTS: The TNF-αlevels in serum and urine and 24 hours proteinuria quantity were reduced significantly after therapy [ (7.8 ±3.9) vs (5.0 ±1.6) fmol mL, (11.9 ±6.8) vs (8.3 ± 3.5) fmol /mL, (2.6 ±2.0) vs (1.0 ±0.5) g, respectively;P <0.01, P <0.05, P <0.01].There was a positive correlation between the 24 hours proteinuria quantity and TNF-αlevels in serum and urine before and after therapy (P <0.01, P <0.05;P < 0.05, P <0.05;respectively). CONCLUSION: The TNF-αlevels in serum and urine were significantly increased in CGN patients, and there was a positive relationship between the TNF-αlevel and 24 hours proteinuria quantity.The Ang Ⅱ blockers could decrease TNF-αlevels in serum and urine, reduce proteinuria, and protect renal function.

Key words: chronic glomerulonephritis, tumor necrosis factor-α, proteinuria, angiotensin Ⅱ

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