阿法骨化醇对IgA肾病患者血清TNF-α、IL-6、TGF-β1水平的影响  

Effect of Alfacalcidol on serum levels of TNF-α,IL-6 and TGF-β1 in patients with IgA nephropathy

作　　者：闫志群[1] 李六生[1] 周志华[1] 刘兰香[1] 

机构地区：[1]三峡大学人民医院宜昌市第一人民医院肾内科,湖北宜昌443000

出　　处：《中国医药导报》2016年第8期150-153,共4页China Medical Herald

摘　　要：目的探讨不同剂量阿法骨化醇对IgA肾病（IgAN）患者血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和转化生长因子-β1（TGF-β1）水平的影响。方法选取2012年10月～2015年2月三峡大学人民医院随访的IgAN患者52例，按随机数字表法分为A组和B组，每组26例。同时选取同一时期健康体检人群30例为正常组。所有IgAN患者均维持原有双倍剂量肾素血管紧张素系统（RAS）阻断剂治疗，其中A组患者口服阿法骨化醇胶丸0．25μg，1粒／d，B组口服阿法骨化醇胶丸0，5μg,1粒／d，疗程均为12周。比较两组患者治疗前后外周血TNF-α、IL-6、TGF-β1、血尿素氮（BUN）、肌酐（Scr）、胱抑素C（Cys-C）及24h尿蛋白定量（UTP）水平的变化。结果与正常组比较，IgAN组患者血清TNF-α、IL-6和TGF-β1水平均明显升高（P〈0．01）。经过12周治疗，两组患者血清TNF-α、IL-6、TGF-β1、Cys-C及24h UTP水平较治疗前均有明显下降，差异均有统计学意义（P〈0．05），B组患者下降更明显，且与A组治疗后比较，差异均有统计学意义（P〈0．05），两组患者治疗前后BUN、Scr比较差异均无统计学意义（P〉0．05）。结论IgAN存在炎症反应，阿法骨化醇能明显降低IgAN患者血清TNF-α、IL-6、TGF-β1水平，降低蛋白尿，改善肾功能，而且0．5μg／d剂量优于O．25耐d剂量。Objective To explore the effect of different doses of Alfacalcidol on serum levels of tumor necrosis factor alpha （TNF-α）, interleukin 6 （IL-6） and transforming growth factor beta 1 （TGF-β1） in patients with IgA nephropathy （IgAN）. Methods 52 patients with IgAN admitted to Three Gorges University People＇s Hospital from October 2012 to February 2015 were selected and randomly divided into group A and group B, with 26 cases in each group. While 30 healthy adults were selected as normal group. On the basis of routine RAS therapy plan, group B was treated with Alfa- calcidol （0.5 μg, once a day） for 12 weeks, while group A was treated with Alfacalcidol （0.25 μg, once a day）. The changes of serum TNF-α, IL-6, TGF-β1, cystainCm（Cys-C）, blood urea nitrogen （BUN）, serum creatinine （Scr） and 24 hours Urinary total protein （UTP） in two groups were compared before and after treatment. Results Compared with nor- mal group, serum TNF-α, IL-6 and TGF-β1 levels were significantly higher than those in IgAN group （P 〈 0.01 ）. After 12 weeks of treatment, the level of TNF-α, IL-6, TGF-β1, Cys-C and 24 h UTP had obviously declined （P 〈 0.05）, compared with that before treatment in two groups, and the reduction of group B was higher than group A （P 〈 0.05）. There was no significant difference in BUN and Scr between the two groups before and after treatment （P 〉 0.05）. Conclusion Inflammation reaction exists in IgAN, Alfacalcidol can significantly reduce TNT-α, IL-6, TGF-β1 level in serum of IgAN patients, reduce albuminuria, improve renal function, and the dose of 0.5 μg/d is better than 0.25 μg/d,

关 键 词：阿法骨化醇 IGA肾病 肿瘤坏死因子-Α 白细胞介素-6 转化生长因子-Β1 

分 类 号：R692.6[医药卫生—泌尿科学]