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糖尿病(diabetic mellitus,DM)的微血管并发症之一是糖尿病肾病(diabetic nephropathy,DN),如今患有慢性肾脏病(chronic kidney disease,CKD)及终末期肾脏疾病(end stage renal disease,ESRD)的人数不断增加,DN对前者的影响是巨大的。在DN的发生发展中,有三种主要通路参与其中,这些通路代表着异常的细胞内代谢、多元醇和蛋白激酶C通路的激活、糖基化终末产物的形成、肾小球高灌注诱导的肾小球内高压。从DN进展到ESRD,高血糖是这三种重要通路的主要上游驱动力量,作为这三种主要通路的下游因素,微炎症及随后发生的细胞外基质扩张是DN进展的共同通路。近几年,研究者已经确信炎症通路在DN的进展中起主要作用,并且针对不同炎性因子给予了相应治疗。本文就炎性因子在DN中的作用及最新的抗炎治疗进行了综述。
One of the microvascular complications of diabetic mellitus (DM) is diabetic nephropathy (DN), and is now suffering from chronic kidney disease (CKD) and end stage renal disease (ESRD) The ever-increasing number of DNs has a huge impact on the former. In the development of DN, there are three major pathways involved in these pathways represent abnormal intracellular metabolism, activation of polyol and protein kinase C pathway, the formation of advanced glycation end products, glomerular hyperoxia-induced kidney Small ball pressure. As DN progresses to ESRD, hyperglycemia is a major upstream driver of these three important pathways. As a downstream factor in these three major pathways, microinflammation and consequent extracellular matrix expansion are the common pathways for DN progression. In recent years, researchers have convinced that the inflammatory pathways play a major role in the progression of DN and have been given treatments for different inflammatory factors. This article reviews the role of inflammatory cytokines in DN and the recent anti-inflammatory treatment.