维生素D3对2型糖尿病急性低钠血症的作用  

The Investigation of VitD3 on Acute Hyponatremia in Type 2 Diabetes

作　　者：陈玲[1] 胡菊桂[2] 

机构地区：[1]武汉大学中南医院综合医疗科,武汉430071 [2]武汉大学中南医院医保部窗口管理办公室,武汉430071

出　　处：《微循环学杂志》2017年第4期47-50,共4页Chinese Journal of Microcirculation

摘　　要：目的:分析维生素D3(VitD3)对2型糖尿病(T2DM)患者急性低钠血症的作用。方法:60例T2DM合并低钠血症患者,随机平分为常规治疗组和VitD3治疗组(VitD3口服,2 000U/天),两组患者均随访1年,每2月一次,检测其血[Na+]、皮质醇、25-羟基VitD3[25-(OH)VitD3]和1,25-二羟基VitD3[1,25-(OH)2VitD3]水平,观察随访1年两组患者发生低钠血症的例次和发生低钠血症时上述指标的变化,以及治疗前后两组有关指标的改善情况。结果:随访1年内共发生169例次低钠血症,VitD3治疗组明显少于常规治疗组(52例次vs 117例次),其发生率差异(30.76%vs 69.23%)有统计学意义(P<0.01);且在低钠血症发生时期,VitD3治疗组[Na+]较常规治疗组明显升高(P<0.05)。经过1年治疗,VitD3治疗组患者[Na+]、25-(OH)VitD3和1,25-(OH)2VitD3水平较治疗前明显提高(P<0.05;P<0.01);常规治疗组患者相同指标则与治疗前无明显差异(P>0.05)。T2DM患者血皮质醇水平在低钠血症时期较血钠正常时期升高,VitD3治疗对血皮质醇水平无明显差异。结论:补充VitD3可以减少T2DM患者低钠血症发生频率。Objective： To evaluate the effect of VitD3 on acute hyponatremia in type 2 diabetes. Method： A total of 60 type 2 diabetic patients with hyponatremia were enrolled. 30 subjects were selected at random to receive vitamin D3 supplement at a dose of 2000U/d. Plasma levels of Na, K, Cl, Serum levels of hydrocortisol, 25 （OH） VitD3 and 1, 25 （OH）2 VitD3 were measured every 2 month. The frequency of hyp0natremia was reported during 1 year of following up. Results： A total of 169 hyponatremia were reported. When comparing With the routine treatment group,the frequency and degree of hyponatremia decreased significantly in VitD3 supplement group and during hyponatremia. Vitamin D3 supplement for 1 year resulted in an increase of serum sodium concentration, 25-（OH） VitD3 and 1,25-（OH）2 VitD3 ,the level of [-Na^＋ ]in the VitD3 group nas increase signifi contly than that in the routine treatment group. 1, 25 （ OH）2 VitD3 level in type 2 diabetic patients. The level of hydrocortisol increased during hyponatremia in type 2 diabetic patients when comparing with normal sodium concentration, and VitD3 supplement has no influence on the level of hydrocortisol. Conclusion： Vitamin D3 supplement decreased hyponatremia fre- quency in patients with type 2 diabetes.

关 键 词：2型糖尿病 低钠血症 维生素D3 

分 类 号：R587.1[医药卫生—内分泌] R589.4[医药卫生—内科学]