阿法骨化醇辅助治疗早期糖尿病肾病对微炎症指标及尿微量白蛋白的影响  

Effect of adjuvant alfacalcidol on early diabetic nephropathy on microinflammation indexes and urine microalbumin

作　　者：罗忠明[1] 梁志丽 周伟谦[1] 廖智威 陈载鑫[1] 杨蕾[1] 邓凤梅[1] LUO Zhongmin;LIANG Zhili;ZHOU Weiqian(Department of Nephrology,Houjie Hospital of Dongguan City,Guangdong Province,Dongguan 523960,China)

机构地区：[1]广东省东莞市厚街医院肾内科,523960

出　　处：《临床合理用药杂志》2020年第17期13-15,共3页Chinese Journal of Clinical Rational Drug Use

基　　金：东莞市社会科技发展项目(No:2018507150231367)。

摘　　要：目的观察阿法骨化醇辅助治疗早期糖尿病肾病对微炎症指标及尿微量白蛋白的影响。方法选取2017年8月-2019年2月东莞市厚街医院收治的早期糖尿病肾病患者60例为研究对象,采取随机数字表法分为对照组和观察组,每组30例。对照组给予基础治疗,观察组给予基础治疗联合阿法骨化醇治疗,比较2组治疗前后肾功能指标[血清肌酐(SCr)、尿素氮(BUN)]、血压[收缩压(SBP)、舒张压(DBP)]、炎性因子[肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)]、24 h尿微量白蛋白水平及药物不良反应发生率。结果2组治疗前后SCr、BUN、SBP、DBP水平比较无显著差异(P>0.05);治疗后,2组TNF-α、IL-6、hs-CRP及24 h尿微量白蛋白水平均低于治疗前,且观察组低于对照组(P<0.01);2组不良反应(食欲不振、恶心呕吐、瘙痒、皮疹)发生率比较差异均无统计学意义(P>0.05)。结论阿法骨化醇辅助治疗早期糖尿病肾病,可降低患者炎性因子及尿微量白蛋白水平,且不良反应发生率低,治疗效果显著,安全性较高。Objective To observe the effect of adjuvant alfacalcidol on early diabetic nephropathy on microinflammation indexes and urine microalbumin. Methods 60 patients with early diabetic nephropathy admitted to Houjie Hospital of Dongguan City from August 2017 to February 2019 were selected as the research subjects. The patients were randomly divided into control group and observation group,30 in each group. The control group was given basic treatment,and the observation group was given basic treatment combined with alfacalcidol. Comparison of renal function indexes[serum creatinine( SCr),urea nitrogen( BUN) ],blood pressure[systolic blood pressure( SBP),diastolic blood pressure( DBP) ],and inflammatory factors[tumor necrosis factor alpha( TNF-α),Interleukin-6( IL-6),high-sensitivity C-reactive protein( hs-CRP) ],24 h urine microalbumin level and incidence of adverse drug reactions were compared before and after treatment. Results There was no significant difference in the levels of SCr,BUN,SBP,and DBP between the two groups before and after treatment( P >0. 05). After treatment,the levels of TNF-α,IL-6,hs-CRP and 24 h urine microalbumin in the two groups were lower than before treatment,and the observation group was lower than the control group( P < 0. 01). There was no statistically significant difference in the incidence of adverse reactions( loss of appetite,nausea and vomiting,itching,rash) between the two groups( P > 0. 05). Conclusion Alfacalcidol adjuvant treatment of early diabetic nephropathy can reduce the level of inflammatory factors and urine microalbumin in patients,and the incidence of adverse reactions is low,the treatment effect is significant,and the safety is high.

关 键 词：糖尿病肾病 阿法骨化醇 微炎症指标 尿微量白蛋白 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]