活性维生素D_3治疗慢性肾脏病(Ⅰ～Ⅲ)的临床观察  

The Clinical Observation of Active Vitamin D_3 Treatment of Chronic Kidney Disease (Ⅰ～Ⅲ)

作　　者：田秋菊[1] 

机构地区：[1]菏泽市立医院肾内科,山东菏泽274031

出　　处：《中国医药指南》2012年第4期23-24,共2页Guide of China Medicine

摘　　要：目的观察活性维生素D3治疗慢性肾脏病(chronic kidney disease,CKD)(Ⅰ～Ⅲ期)的疗效及安全性,旨在探讨治疗CKD(Ⅰ～Ⅲ期)安全、有效的新方法。方法将符合CKD(Ⅰ～Ⅲ期)的100例住院患者随机分为活性维生素D3治疗组(n=50)和对照组(n=50)根据不同的病因,尿蛋白定量、肾功能情况、病理类型及血压等情况给予相应的常规治疗。治疗组在对照组的基础上给予活性维生素D3(骨化三醇)1.0mg/d口服,观察12周,主要观察尿蛋白量下降程度、肾功能变化情况及血清钙、磷水平。结果治疗组尿蛋白显著下降[(3.99±1.25)g vs(1.05±0.33)g/24h,P<0.01],血尿素氧(BUN)、血肌酐(Scr)亦明显下降。[(6.8±3.1)mmol/L vs(4.2±1.1)μmol/L,P<0.05]、[(128.5±60.5)μmol/L vs(98±40.1)μmol/L,P<0.05]。对照组尿蛋白亦明显下降[(3.73±1.32g)vs(2.11±0.98)g/24h,P<0.05],BUN,Scr无明显变化,[(7.0±2.8)mmol/L vs(6.8±1.4)mmol/L,P>0.05],[(130.1±61.8)μmol/L VS(129±50.3)μmol/L,P>0.05],两组血清钙均略有升高,但无统计学差异。结论活性维生素D3能明显减少CKD(Ⅰ～Ⅲ期)患者尿蛋白,延缓肾功能进展,疗效优于对照组,且无明显副作用,是治疗CKD(Ⅰ～Ⅲ期)安全,有效的药物。Objective To Observe the efficacy and safety of the active vitamin D3 to treat chronic kidney disease （CKD） （Ⅰ- Ⅲ period）. To investigate the safe and effective new methods to treat CKD （Ⅰ- Ⅲ period）. Methods 100 hospitalized patients who were consistent with CKD （Ⅰ- Ⅲ period） were randomly divided into the active vitamin D3 treatment group （n = 50） and the control group （n = 50）. Depending on the cause of disease, urine protein, renal function, pathology and blood pressure, etc. the control group were given the corresponding conventional treatment. On the basis of treatment in the control group, the treatment group were given active vitamin D3 （calcitriol） 1.0μg / d orally. Having Observed for 12 weeks. Observed decline in the major urinary protein level, changes in renal function and serum colcium and phosphorus levels. Results The urinary protein in the treatment group decreased significantly [（3.99 ± 1.25） vs （1.05 ± 0.33） g/24h, P〈 0.01], blood urea nitrogen （BUN）, serum creatinine （Scr） also decreased significantly. [（6.8 ± 3.1） mmol / L vs （4.2± 1.1） mmol/L, P〈 0.05], [（128.5 ± 60.5） μmol/L vs （98 ±40.1） μmol/L, P〈 0.05]. The urinary protein of the control group also decreased. [（3.73 ± 1.32） g vs （2.11 ± 0.98） g/24h, P〈0.05]. BUN and Scr had no significant changes. [（7.0 ± 2.8） mmol/L vs （6.8 ± 1.4） mmol/L, P〉0.05], [（130.1 ± 61.8） μmol / L vs （129 ± 50.3） μmol/L, P〉 0.05]. The serum calcium in two groups was slightly higher, but not significantly. Conclusion The active vitamin D3 can significantly reduce the CKD （Ⅰ～Ⅲ stage） in patients with urinary protein, slow down the progress of renal function, is more effective than the control group with no significant side effects. It is the safe and effective drugs to treat CKD （Ⅰ～Ⅲ stage）.

关 键 词：慢性肾脏病 活性维生素D3 

分 类 号：R692[医药卫生—泌尿科学]