中国血液净化

中国血液净化 ›› 2015, Vol. 14 ›› Issue (12): 718-722.doi: 10.3969/j.issn.1671-4091.2015.12.005

• 临床研究 • 上一篇    下一篇

虾青素协助改善IgA肾病患者尿蛋白的研究

牛慧敏,甘良英,武蓓,燕宇,王宓,左力   

  1. 北京大学人民医院肾内科
  • 收稿日期:2015-10-10 修回日期:2015-09-28 出版日期:2015-12-12 发布日期:2015-12-12
  • 通讯作者: 左力：ZuoLiMD@Hotmail.com E-mail:zuoli@bjmu.edu.cn

A study on reducing urinary protein by astaxanthin in patients with IgA nephropathy

  • Received:2015-10-10 Revised:2015-09-28 Online:2015-12-12 Published:2015-12-12

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摘要： 目的研究虾青素是否可协助降低IgA 肾病患者尿蛋白排泄量。方法这是1 项患者自身对照研究。从2014 年12 月至2015 年6 月期间在北京大学人民医院肾内科门诊就诊的IgA 肾病患者中选择3 个月来尿蛋白稳定、肾功能稳定，预计不需要降压药物调整的患者。符合条件并愿意接受虾青素治疗的患者共17 例，完成本研究者16 例，平均年龄为45.4±13.4 岁，男性7 例、女性9 例。给予虾青素1 日2 次，1 次1～2 粒，连续口服治疗3 个月，服用药物前、开始服药后每个月检查24h 尿蛋白定量(24hUP)、血清白蛋白(Alb)、肌酐(Scr)、估算肾小球滤过率(eGFR)、总胆固醇(TChol)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)和三酰甘油(TG)，共4 次。用方差分析(ANOVA 检验)比较正态分布的资料(治疗前后TChol、HDL和LDL)；用Friedman 非参数检验比较非正态分布的资料(治疗前后24hUP、Alb、Scr、eGFR 和TG)，并用Wilcoxon 秩和检验进行两两比较、用Jonckheere-Terpstra 法进行趋势分析。结果患者24hUP、Alb、Scr、eGFR、TChol、HDL、LDL 和TG 基线值分别为[2.65(1.43,5.02)]g/d、[41.0(37.6,44.2)]g/L、[135.0 (95.0,224.0)]μmol/L、[47.81 (32.91,65.39)]ml/min.1.73m2、(5.83±1.43) mmol/L、(1.29±0.37)
mmol/L、(3.20±0.86)mmol/L 和[1.26(1.03，3.78)]mmol/L；治疗结束时分别为[1.35(0.86，2.96)]g/d、[42.3(40.5,42.7)]g/L、[154.0(70.0,192.0)]μmol/L、[41.49(32.50,100.51)]ml/min.1.73m2、(5.32 ±1.12)mmol/L、(1.12±0.32)mmol/L、(3.28±0.82)mmol/L 和[1.49(1.04,2.75)]mmol/L。4 次24hUP 及eGFR 经检验存在显著的下降趋势(P＜0.001)；Scr 经检验存在显著的上升趋势(P＜0.001)。治疗后未发现Alb、TChol、HDL、LDL 和TG 有显著性变化。结论研究表明虾青素可降低IgA 肾病患者24h 尿蛋白定量。

关键词: 虾青素, IgA肾病, 24h尿蛋白定量

Abstract: 【Abstract】Objective The aim of the current study was to investigate whether astaxanthin could reduce urinary protein excretion in patients with IgA nephropathy. Methods This was a self- controlled study. Patients diagnosed with IgA nephropathy and treated in our hospital in the period between Dec. 2014 and Jun. 2015 were recruited. They had stable urinary protein excretion for at least 3 months, stable renal function and steady doses of antihypertensives. Seventeen patients met the criteria and were willing to accept astaxanthin treatment, and 16 (45.4±13.4 years, 7 males and 9 females) of them completed the study. All patients received oral astaxanthin 1～2 tablets each time, twice daily for 3 month. 24h urinary protein (24hUP), serum albumin (Alb), creatinine (Scr), estimated glomerular filtration rate (eGFR), total cholesterol (TChol), high density lipoprotein (HDL), low density lipoprotein (LDL) and triglyceride (TG) were measured before taking astaxanthin and re-examined after the treatment once a month for 3 months. Normally distributed data (TChol, HDL and LDL) were analyzed using one- way analysis of variance (ANOVA). Non- normally distributed data (24hUP, Alb, Scr, eGFR and TG) were analyzed using Friedman non-parametric test. Wilcoxon rank sum test was used for pairwise comparison. Jonckheere-Terpstra was used for trend analysis. Results At baselines, 24hUP, Alb, Scr, TChol, eGFR, HDL, LDL and TG was 2.65 (1.43, 5.02) g/d, 41.0 (37.6, 44.2) g/L, 135.0 (95.0, 224.0) μmol/L, 47.81 (32.91, 65.39) ml/min.1.73m2, 5.83±1.43 mmol/L, 1.29±0.37 mmol/L, 3.20±0.86 mmol/L and 1.26 (1.03,3.78) mmol/L, respectively, and changed to 1.35 (0.86,2.96) g/d, 42.3 (40.5,42.7) g/L,
154.0 (70.0,192.0) μmol/L, 41.49 (32.50,100.51) ml/min.1.73m2, 5.32 ± 1.12 mmol/L, 1.12 ± 0.32 mmol/L, 3.28±0.82 mmol/L and 1.49 (1.04,2.75) mmol/L, respectively, after the treatment for 3 months. After astaxanthin treatment, 24hUP and eGFR had a significantly downward trend (P＜0.001), Scr had a significantly up- ward trend (P＜0.001), but change trends of Alb, TChol, HDL, LDL and TG were not found. Conclusions These results suggested that urinary protein excretion could be reduced by adding astaxanthin to traditional treatment in patients with IgA nephropathy.

Key words: astaxanthin, IgA nephropathy, urinary protein.