中文摘要：

目的 观察雷公藤多苷对早期糖尿病肾病（DKD）微炎症状态的影响。方法 选取2014年7月～2015年9月潍坊市益都中心医院肾脏内科和糖尿病科收治的糖尿病患者共97例,选择健康体检者40名作为正常对照组。根据尿白蛋白/肌酐（ACR）水平将97例患者分为无蛋白尿组（DM组）30例及蛋白尿组（早期DKD组）67例。早期DKD组患者随机分为雷公藤多苷治疗组（A组）及一般治疗组（B组）。观察6个月,比较各组患者治疗前后血清白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、高敏C反应蛋白（hs-CRP）等微炎症因子及ACR水平,分析其相关性。结果 早期DKD组hs-CRP、IL-6、TNF-α、ACR水平较DM组明显增高（P〈0.01）,且两组各因子水平均显著高于正常对照组（P〈0.05）;ACR与血清hs-CRP、IL-6、TNF-α水平呈正相关（r=0.895、0.701、0.616,均P〈0.01）。A组治疗后hs-CRP、TNF-α、ACR水平较治疗前显著降低（P〈0.05）,且明显低于B组治疗后（P〈0.05）;B组治疗前后上述指标差异无统计学意义（P〉0.05）。结论 微炎症状态持续存在于DKD整个病程中,是DKD发生发展的关键因素,与ACR密切相关。雷公藤多苷能够显著降低DKD的炎症因子及ACR水平,能为DKD患者带来全新有效的诊治手段。

英文摘要：

Objective To observe the effects of Tripterygium Glycosides on the microinflammation state of patients with early diabetic kidney disease （DKD）. Methods 97 patients with diabetes were selected in Nephrology and Diabetes Departments of Weifang Yidu Central Hospital Affiliated to Weifang Medical College from July 2014 to September 2015. 40 healthy physical examination persons were selected as normal control group. Patients were divided into non-proteinuria group （DM group, n=30） and proteinuria group （early DKD group, n=67） according to the level of urinary albumin- to-creatinine ratio （ACR）. Patients with early DKD were randomly divided into the Tripterygium Glycosides treatment group （group A） and common treatment group （group B）. All groups were observed 6 months. The levels of interleukin- 6 （IL-6）, tumor necrosis factor-α （TNF-α）, high sensitivity C-reactive protein （hs-CRP） and ACR were compared in each group, while the relationships among them were analyzed. Results The levels of IL-6, TNF-α, hs-CRP and ACR in early DKD group were obviously higher than those in the DM group （P 〈 0.01）; which in both DM group and early DKD group were significantly higher than those in the normal control group （P 〈 0.05）. ACR was positively correlated to the levels of hs-CRP, IL-6 and TNF-α （r=0.895, 0.701, 0.616. all P 〈 0.01）. The levels of hs-CRP, TNF-αand ACR in group A were decreased significantly after treatment than before treatment （P 〈 0.05）, which in group A after treatment were significantly lower than group B （P 〈 0.05）. There were no significant differences in levels of hs-CRP, TNF-α and ACR between before and after treatment in gorup B （P 〉 0.05）. Conclusion The microinflammation state persists in total course of DKD and aggravates in the progress. The microinflammation state is the key factor of the progress of DKD and has closely correlated with ACR. Tripterygium Glycosides can obviously decrease the levels of inflammatory factors and