中国当代医药
中國噹代醫藥
중국당대의약
PERSON
2015年
17期
123-125,128
,共4页
占宏静%邝山%陈秋霞%黄沛强%梁博闻
佔宏靜%鄺山%陳鞦霞%黃沛彊%樑博聞
점굉정%광산%진추하%황패강%량박문
骨化三醇%糖尿病肾病%血钙%蛋白尿%高敏C反应蛋白
骨化三醇%糖尿病腎病%血鈣%蛋白尿%高敏C反應蛋白
골화삼순%당뇨병신병%혈개%단백뇨%고민C반응단백
Calcitriol%Diabetic nephropathy%Blood calcium%Proteinuria%High-sensitivity C-reactive protein
目的：探讨骨化三醇辅助治疗糖尿病肾病(DN)的临床效果。方法选择2013年7月~2014年7月本院收治的40例DN患者，根据患者意愿随机分为对照组和治疗组，每组20例。两组均接受控制血压、血糖等基础治疗，治疗组在此基础上加服骨化三醇，两组疗程均为4周。测定两组患者体内血清25-羟维生素D[25-(OH)D]、Ca2+、脂联素(APN)、高敏C反应蛋白(hs-CRP)、血肌酐(SCr)、24 h尿蛋白定量(24 h pro)等指标，并比较两组临床疗效。结果治疗后4周，两组患者血清25-(OH)D、Ca2+含量比治疗前显著升高(P<0.05或P<0.01)，APN、hs-CRP、24 h pro水平显著降低(P<0.05或P<0.01)，且治疗组较对照组的各项生化指标变化更为显著，差异有统计学意义(P<0.05)。结论早期DN患者体内1，25-二羟维生素D3明显缺乏，炎性因子水平较高，适量补充骨化三醇能有效地改善患者血清25-(OH)D、Ca2+水平，对胰岛具有保护作用，维持正常胰岛素分泌和抑制胰岛素抵抗，并且能显著地降低患者体内APN、hs-CRP水平，抑制炎症反应，减少尿蛋白排泄，保护肾功能。
目的：探討骨化三醇輔助治療糖尿病腎病(DN)的臨床效果。方法選擇2013年7月~2014年7月本院收治的40例DN患者，根據患者意願隨機分為對照組和治療組，每組20例。兩組均接受控製血壓、血糖等基礎治療，治療組在此基礎上加服骨化三醇，兩組療程均為4週。測定兩組患者體內血清25-羥維生素D[25-(OH)D]、Ca2+、脂聯素(APN)、高敏C反應蛋白(hs-CRP)、血肌酐(SCr)、24 h尿蛋白定量(24 h pro)等指標，併比較兩組臨床療效。結果治療後4週，兩組患者血清25-(OH)D、Ca2+含量比治療前顯著升高(P<0.05或P<0.01)，APN、hs-CRP、24 h pro水平顯著降低(P<0.05或P<0.01)，且治療組較對照組的各項生化指標變化更為顯著，差異有統計學意義(P<0.05)。結論早期DN患者體內1，25-二羥維生素D3明顯缺乏，炎性因子水平較高，適量補充骨化三醇能有效地改善患者血清25-(OH)D、Ca2+水平，對胰島具有保護作用，維持正常胰島素分泌和抑製胰島素牴抗，併且能顯著地降低患者體內APN、hs-CRP水平，抑製炎癥反應，減少尿蛋白排洩，保護腎功能。
목적：탐토골화삼순보조치료당뇨병신병(DN)적림상효과。방법선택2013년7월~2014년7월본원수치적40례DN환자，근거환자의원수궤분위대조조화치료조，매조20례。량조균접수공제혈압、혈당등기출치료，치료조재차기출상가복골화삼순，량조료정균위4주。측정량조환자체내혈청25-간유생소D[25-(OH)D]、Ca2+、지련소(APN)、고민C반응단백(hs-CRP)、혈기항(SCr)、24 h뇨단백정량(24 h pro)등지표，병비교량조림상료효。결과치료후4주，량조환자혈청25-(OH)D、Ca2+함량비치료전현저승고(P<0.05혹P<0.01)，APN、hs-CRP、24 h pro수평현저강저(P<0.05혹P<0.01)，차치료조교대조조적각항생화지표변화경위현저，차이유통계학의의(P<0.05)。결론조기DN환자체내1，25-이간유생소D3명현결핍，염성인자수평교고，괄량보충골화삼순능유효지개선환자혈청25-(OH)D、Ca2+수평，대이도구유보호작용，유지정상이도소분비화억제이도소저항，병차능현저지강저환자체내APN、hs-CRP수평，억제염증반응，감소뇨단백배설，보호신공능。
Objective To analyze the clinical effect of calcitriol assisted treatment for diabetic nephropathy (DN). Methods 40 patients with DN admitted into our hospital from July 2013 to July 2014 were selected,and they were evenly divided into control group and treatment group based on their own will in random.The basic treatment such as control of blood pressure and blood sugar was provided in the two groups.In the treatment group,on the basis of the ba-sic treatment,calcitriol was added,and courses of treatment lasted 4 weeks in the two groups.Levels of 25-hydroxy vita-min D [25-(OH)D],Ca2+,adiponectin (APN),high-sensitivity C-reactive protein (hs-CRP),serum creatinine (SCr),24 hours urinary protein quantity (24 h pro) and other biochemical indexes before and after treatment were determined in two groups,and the clinical effect of two groups was compared. Results After 4 weeks treatment,content of serum 25-(OH) D and Ca2+was greatly increased in the two groups compared with those before treatment (P<0.05 or P<0.01).The levels of APN,hs-CRP,24 h pro levels was significantly decreased (P<0.05 or P<0.01).The changes of biochemical indexes af-ter therapy in treatment group was remarkably improved in comparison with those in control group,which displayed sta-tistical differences (P<0.05). Conclusion 1,25-dihydroxy vitamin D3 is in shortage in early-stage DN patients and the level of inflammatory factors is higher.Appropriate supplementation of calcitriol can effectively improve serum 25-(OH) D and Ca2+ levels in DN patients, which plays a protective effect on the pancreas islet by maintaining normal insulin secretion and inhibiting insulin resistance,greatly decreases the levels of APN and hs-CRP,resists inflammatory re-sponse,reduces urinary albumin excretion,and protect renal function.
