奥美沙坦酯联合骨化三醇治疗对早期2型糖尿病肾病患者炎症状态及肾间质纤维化的影响  

Effect of olmesartan axetil combined with calcitriol on inflammatory status and renal interstitial fibrosis in patients with early type 2 diabetic nephropathy

作　　者：魏莉娟 郭姣姣[1] 何双红[1] 王静[1] WEI Li-juan;GUO Jiao-jiao;HE Shuang-hong(General Practice Center,West China Hospital,Sichuan University,Chengdu Sichuan 610000,China)

机构地区：[1]四川大学华西医院全科医学中心,四川成都610000

出　　处：《临床和实验医学杂志》2023年第4期364-367,共4页Journal of Clinical and Experimental Medicine

基　　金：四川省卫生健康委员会科研课题(编号:20PJ003)。

摘　　要：目的研究奥美沙坦酯联合骨化三醇治疗对早期2型糖尿病肾病(T2DN)患者炎症状态及肾间质纤维化的影响。方法以回顾性分析为法,观察对象为2020年1月至2022年1月入四川大学华西医院的100例早期T2DN患者,根据不同治疗方法分为研究组(n=50)与对照组(n=50)。研究组联用奥美沙坦酯、骨化三醇治疗,对照组单用奥美沙坦酯治疗,持续用药8周。比较两组患者治疗前后炎症指标[C反应蛋白(CRP)、降钙素原(PCT)]、肾间质纤维化指标[血清同型半胱氨酸(Hcy)、血管内皮生长因子(VEGF)、转化生长因子β1(TGF-β1)]、血糖指标[糖化血红蛋白(HbA1c)、餐后2 h血糖(2 hPG)、空腹血糖]水平、肾功能指标[肾小球滤过率(GFR)、血尿素、血肌酐]水平与治疗后总有效率、不良反应(恶心呕吐、头晕头痛、发热、胃肠道反应)发生率。结果治疗8周后,两组患者的CRP、PCT、Hcy、VEGF、TGF-β1、HbA1c、2 hPG、空腹血糖、血尿素、血肌酐水平较治疗前明显下降,GFR较治疗前明显升高,差异均有统计学意义(P<0.05);研究组患者的CRP、PCT、Hcy、VEGF、TGF-β1、HbA1c、2 hPG、空腹血糖、血尿素、血肌酐水平为(14.36±2.04)mg/L、(1.21±0.08)μg/L、(13.79±1.72)μmol/L、(346.91±23.82)pg/mL、(152.97±18.92)pg/mL、(5.81±0.65)%、(8.36±1.24)mmol/L、(6.18±1.06)mmol/L、(4.27±1.08)mmol/L、(71.28±11.15)μmol/L,较对照组[(16.32±2.26)mg/L、(1.44±0.11)μg/L、(19.34±2.48)μmol/L、(394.36±25.11)pg/mL、(169.04±19.75)pg/mL、(6.42±0.76)%、(10.28±1.39)mmol/L、(7.81±1.12)mmol/L、(5.61±1.16)mmol/L、(78.41±12.37)μmol/L]更低,GFR为(93.85±8.62)mL·min^(-1)·1.73 m^(-2),较对照组[(86.29±8.93)mL·min^(-1)·1.73 m^(-2)]更高,差异均有统计学意义(P<0.05)。研究组患者的治疗总有效率为98.00%,明显高于对照组(84.00%),差异有统计学意义(P<0.05)。两组患者恶心呕吐、头晕头痛、发热、胃肠道反应发生率比较,差异无统计学意义(P>0.05)�Objective To investigate the effect of olmesartan axetil combined with calcitriol on inflammatory status and renal interstitial fibrosis in patients with early type 2 diabetic nephropathy(T2DN).Methods A total of 100 patients with early T2DN admitted to West China Hospital,Sichuan University from January 2020 to January 2022 were retrospectively analyzed.According to different treatment methods,they were divided into study group(n=50)and control group(n=50).The study group was treated with olmesartan ester and calcitriol,while the control group was treated with olmesartan ester alone.The drug was administered continuously for 8 weeks.The inflammatory indicators[C-reactive protein(CRP),procalcitonin(PCT)],renal interstitial fibrosis indicators[homocysteine(Hcy),vascular endothelial growth factor(VEGF),transforming growth factor-β1(TGF-β1)],blood glucose indicators[glycosylated hemoglobin(HbA1c),postprandial 2 h blood glucose(2 hPG),fasting blood glucose],renal function indicators[glomerular filtration rate(GFR),blood urea(BUN),serum creatinine(Scr)]were compared between the two groups before and after treatment,and the total effective rate after treatment,the incidence of adverse reactions(nausea and vomiting,dizziness,headache,fever,gastrointestinal reactions)were compared between the two groups.Results After 8 weeks of treatment,the levels of CRP,PCT,Hcy,VEGF,TGF-β1,HbA1c,2 hPG,fasting blood glucose,blood urea and Scr in the two groups were significantly decreased compared with those before treatment,and GFR was significantly increased compared with those before treatment(P<0.05);the levels of CRP,PCT,Hcy,VEGF,TGF-β1.HbA1c,2 hPG,fasting blood glucose,blood urea,and blood creatinine of patients in the study group were(14.36±2.04)mg/L,(1.21±0.08)μg/L,(13.79±1.72)μmol/L,(346.91±23.82)pg/mL,(152.97±18.92)pg/mL,(5.81±0.65)%,(8.36±1.24)mmol/L,(6.18±1.06)mmol/L,(4.27±1.08)mmol/L,(71.28±11.15)μmol/L,which were lower than those in the control group[(16.32±2.26)mg/L,(1.44±0.11)μg/L,(19.34±2.48)μmol/L

关 键 词：2型糖尿病肾病 奥美沙坦酯 骨化三醇 炎症状态 肾间质纤维化 

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