摘要
目的探讨银杏叶提取物(GBE)对糖尿病肾病(DKD)患者的临床疗效及其对外泌体微小RNA-342-3p(miR-342-3p)水平的影响。方法选取2022年5月至2022年9月杭州市富阳区第一人民医院内分泌科门诊就诊及住院治疗的95例DKD患者作为研究对象,并采用随机数字表法将其分为对照组(50例)和观察组(45例)。对照组依据中国2型糖尿病防治指南(2020年版)进行标准规范治疗,观察组在对照组的基础上联合GBE。比较两组患者治疗前后尿微量白蛋白/尿肌酐比值(UACR)、血肌酐(Scr)、尿素氮(BUN)、空腹血糖(FBG)、糖化血红蛋白(HbA_(1c))、胰岛素抵抗指数(HOMA-IR)、低密度脂蛋白胆固醇(LDL-C)、白细胞(WBC)、血红蛋白(Hb)、血小板(PLT)、丙氨酸转氨酶(ALT)和天冬氨酸氨基转移酶(AST)、尿外泌体miR-342-3p表达水平。结果治疗前,两组患者间UACR、Scr、BUN、FBG、HbA_(1c)、HOMA-IR、LDL-C、WBC、Hb、PLT、ALT、AST及外泌体miR-342-3p表达水平比较,差异均无统计学意义(P均>0.05)。治疗6个月后,观察组与对照组患者的UACR(t=4.012、9.250,P均<0.001)、FBG(t=14.618、6.353,P均<0.001)、HbA_(1c)(t=10.661、5.715,P均<0.001)、HOMA-IR(t=6.658、3.225,P均<0.001)、LDL-C(t=16.968、19.197,P均<0.001)及miR-342-3p表达水平(t=63.635、36.801,P均<0.001)较治疗前均显著降低,且观察组的UACR(t=3.299,P=0.001)、FBG(t=3.114,P=0.002)、HbA_(1c)(t=2.127,P=0.036)、HOMA-IR(t=2.736,P=0.007)、LDL-C(t=2.805,P=0.006)及miR-342-3p表达水平(t=4.379,P<0.001)均更低。而两组患者治疗前后WBC、Hb、PLT、ALT和AST水平比较,差异均无统计学意义(P均>0.05)。结论GBE对DKD患者具有一定的肾脏保护作用,能有效降低UACR,调节血糖和血脂,改善胰岛素抵抗,可能与下调外泌体miR-342-3p表达水平有关。
Objective To investigate the clinical efficacy of ginkgo biloba extract(GBE)on patients with diabetic kidney disease(DKD)and its influence on exosome microRNA-342-3p(miR-342-3p).Methods A total of 95 DKD patients who received outpatient treatment or inpatient treatment in the Department of Endocrinology of the First People's Hospital of Fuyang,Hangzhou from May 2022 to September 2022 were included and divided into a control group(n=50)and an observation group(n=45)by the random number table.The control group received standard treatment according to the"Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes(2020 Edition)",and the observation group was treated with GBE on the basis of the control group.The levels of urinary albumin/creatinine ratio(UACR),serum creatinine(Scr),blood urea nitrogen(BUN),fasting blood glucose(FBG),glycated haemoglobin A1c(HbA_(1c)),homeostasis model assessment-insulin resistance(HOMA-IR),low-density lipoprotein cholesterol(LDL-C),white blood cells(WBC),hemoglobin(Hb),platelets(PLT),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and urinary exosome miR-342-3p were compared between the two groups before and after treatment.Results Before treatment,there were no significant differences in the levels of UACR,Scr,BUN,FBG,HbA1c,HOMA-IR,LDL-C,WBC,Hb,PLT,ALT,AST and exosome miR-342-3p between the two groups(all P>0.05).After six months of treatment,the levels of UACR(t=4.012,9.250;both P<0.001),FBG(t=14.618,6.353;both P<0.001),HbA_(1c)(t=10.661,5.715;both P<0.001),HOMA-IR(t=6.658,3.225;both P<0.001),LDL-C(t=16.968,19.197;both P<0.001)and miR-342-3p(t=63.635,36.801;both P<0.001)of the observation group and control group were significantly lower than those before treatment.Meanwhile,the levels of UACR(t=3.299,P=0.001),FBG(t=3.114,P=0.002),HbA1c(t=2.127,P=0.036),HOMA-IR(t=2.736,P=0.007),LDL-C(t=2.805,P=0.006)and miR-342-3p(t=4.379,P<0.001)were lower in the observation group than in the control group after treatment.However,there were no significant differences in the levels of WBC,Hb,PLT,ALT and AST between the two groups before and after treatment(all P>0.05).Conclusion With a certain renal protection effect,GBE can effectively reduce UACR,regulate blood sugar and lipid,and improve insulin resistance in DKD patients,which may be related to the down-regulation of the exosome miR-342-3p level.
作者
费扬
赵晗希
孙丽琴
楼琴华
胡骏程
Yang Fei;Hanxi Zhao;Liqin Sun;Qinhua Lou;Juncheng Hu(Department of Endocrinology,the First People's Hospital of Fuyang,Hangzhou,Hangzhou 311400,China;The Second School of Clinical Medicine,Zhejiang Chinese Medicine University,Hangzhou 310053,China)
出处
《中华危重症医学杂志（电子版）》
CAS
CSCD
2024年第3期219-224,共6页
Chinese Journal of Critical Care Medicine:Electronic Edition
基金
浙江省中医药科技计划项目(2021ZB247)。
作者简介
通信作者:费扬,Email:fyz20050822@sina.com。
