早期糖尿病肾病患者1,25-(OH)_2D_3及炎性因子的变化及骨化三醇胶丸的干预作用  

Early diabetic nephropathy 1,25-(OH)_2D_3 and changes of inflammatory factors and effect of calcitriol capsules

作　　者：段晓星[1] 常永丽[1] 智淑清[1] 

机构地区：[1]内蒙古医科大学附属医院肾脏内科,呼和浩特010050

出　　处：《疑难病杂志》2014年第4期378-380,共3页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察维生素D代谢物1,25-二羟维生素D_3[1,25-(OH)_2D_3]对早期糖尿病肾病(DN)患者炎性因子TGF-β、TNF-α、IL-6、hs-CRP水平的影响。方法2型糖尿病患者150例,其中单纯糖尿病患者60例为DM组,早期DN 90例为DN组。DN组再随机分为治疗亚组和对照亚组各45例。对照亚组常规治疗,治疗亚组常规治疗+骨化三醇胶丸,疗程均3个月,比较各组1,25-(OH)_2D_3、24 h尿蛋白定量及相关炎性因子的变化。结果治疗前,DN组1,25-(OH)_2D_3水平低于DM组(P<0.05);TGF-β、TNF-α、IL-6、hs-CRP,24 h尿蛋白定量、SCr水平均高于DM组(P<0.05);治疗亚组治疗后TGF-β、TNF-α、IL-6、hs-CRP水平及24 h尿蛋白定量均较治疗前降低(P<0.05),1,25-(OH)_2D_3水平较前升高(P<0.05)。对照亚组与治疗亚组不良反应发生率比较差异无统计学意义(11.1】%vs.11.11%,P>0.05)。结论早期DN患者1,25-(OH)_2D_3缺乏,炎性因子水平增高,补充骨化三醇胶丸可以改善炎性反应状态。Objective To observe the effects of vitamin D metabolites 1,25-dihydroxy vitamin D3[1,25-（OH）2D3] on early diabetic nephropathy （DN） in patients with inflammatory factors TGF-β, TNF-α, IL-6, hs-CRP level.Methods 150 patients with type 2 diabetes, in which 60 patients with diabetes alone as the DM group , 90cases of early DN as DN group.DN group was randomly divided into sub-treatment group and sub-control group with each group of 45 cases.Control subgroup received conventional treatment , treatment subgroup received conventional therapy ＋calcitriol capsules , after 3 months of treatment 1,25-（OH）2D3,24 h urinary protein and related inflammatory factors changes were compared among groups.Results Before treatment, DN group＆#39;s 1,25-（OH）2D3 levels lower than the DM group （ P 〈0.05）;TGF-β, TNF-α, IL-6, hs-CRP, 24 h urinary protein, SCr levels were higher than the DM group （ P 〈0.05）; after treatment, treatment subgroup＆#39;s TGF-β, TNF-α, IL-6, hs-CRP levels and 24 h urinary protein quantitative lower than before treatment （ P 〈0.05）,1,25-（OH）2D3 levels increased compared with the previous （ P 〈]0.05）.Poor control and treatment subgroup reac-tion rate difference was not statistically significant （11.11%vs.11.11%, P 〉0.05）.Conclusion Early DN patients＆#39;1, 25-（ OH） 2 D3 deficiency , levels of inflammatory cytokines increased , complement calcitriol capsules can improve inflammatory state.

关 键 词：糖尿病肾病 1 25-二羟维生素D3 炎性因子 骨化三醇胶丸 1 25-dihydroxy VITAMIN D3 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]