| Recently it is known that the pathogenesis of diabetic nephropathy is related with abnormal secretion of various kinds of cytokines, such as angiotensin II (AgII ) ,endothelins(ET) , transforming growth factor(TGF-B) ,and insulin like growth factor et al, the people has paid attention to the effect of cytokine in the onset and development of diabetic nephropathy, and try to utilize the inhibitor to block the onset and development.Calcitonin gene related peptide ( CGRP) is the strongest expanding blood vessel material at present, and to promote vessel endothelial cell proliferation and adjust the function of many immunologic cell, so CGRP has important action in mediate endothelial cell function in various macroangiopathy and microangiop-athy.At present it is unclear of the relationship of Calcitonin gene related peptide and diabetic nephropathy. The article adopt the radioimmumonassy method to assay the plasma level of CGRP and ET of patients with the different state diabetic nephropathy and to research the correlation with CGRP and ET and diabetic nephropathy, and to carry out the intervention study with angiotensin receptor inhibitor. By observe the effect of angiotensin receptor to CGRP and ET in the inhibitor microalburninuria group and clinical proteinuria group, to provide the clinical basis of the therapy of ARBS.MethodsIt is elected that the number of the diabetic patients in hospital and specialclinic service is 71 cases and the number of the people in healthy is 20 cases. At first the level of UAER is estimated in patients with diabetes, and on the basis of the level of UAER(ug/min) it is grouped in three groups-, normal proteinuria group(NA,UAER < 20):20 cases; microalbumenuia group (MA, 20 < UAER < 200) :26 cases; clinical proteinuria group(ODN,UAER >200) :25;randomly to choose 13 cases in MA group and 12 cases in ODN group is treated in intervention study by ARBS for one month, the medicine is lorsatan, (50mg, taken orally one time every day). To adopt the radioimmumonassy method to assay the plasma level of CGRP ET in patients with diabetes and diabetic nephropathy and after one month to assay the changing levels of CGRP ET and UAER of the patients in intervention therapy by ARBS and no intervention therapy, and to assay the blood pressure, blood lipid, blood sugar, kidney funtion, et al clinical indexes in all cases.Results1. There is significant difference in blood pressure, blood lipid, blood sugar, kidney function in various groups( P <0.01) .2. The plasma level of CGRP is lowered in patients with diabetes and diabetic nephropathy than normal people ( P < 0. 01 ) ; the plasma level of ET is highed in patients with diabetes and diabetic nephropathy than normal people ( P<0.01)3. The plasma level of CGRP is increased by ARBS therapy in patients with diabetes and diabetic nephropathythan normal people (P<0.01);the plasma level of ET is decreased by ARBS therapy in patients with diabetes and diabetic nephropathy than normal people ( P <0.01) ;there are no changes of the plasma levels of CGRP ,ET,UAER in patients by rule therapy group.4. ET has positive relation with course, blood sugar, triglyceride(P <0. 01) and no relation with body mass index and age(P >0.05).5. CGRP and ET have strong relation with UAER( rCGRP = -0.447 rET = 0. 662, p < 0. 01) ; CGRP have strong negative relation with ET ( r = - 0.599,P<0.01).Conclusion1. The plasma level of CGRP is lowered in patients with diabetes than people in control, the plasma level of ET is highed in patients with diabetes than people in control, there are apparent changes of the plasma level of CGRP and ET in patients with diabetic nephropathy; CGRP and ET have strong relation with UAER , so the change of the levels of CGRP and ET is one of pathogenesis mechanism.2. It is showed the antagonistic action between two factorsthat CGRP have strong negative relation with ET.3. ET has positive relation with course, blood sugar, triglyceride(P <0. 01) and no relation with body mass index a...
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