25-羟维生素D_3治疗2型糖尿病患者早期肾损害的临床观察

Clinical observation of 25-hydroxy vitamin D_3 in the treatment of early renal damage in patients with type 2 diabetes mellitus

目的观察25-羟维生素D3(Vit D3)对2型糖尿病(T2DM)患者早期肾损害的临床疗效。方法纳入T2DM早期肾损伤患者80例,采用随机数字表法等分为治疗组与对照组,对照组继续原有降糖方案,治疗组在既往用药基础上,肌肉注射Vit D3注射液,疗程均为10个月,治疗结束后进行疗效评价。结果 1与治疗前相比,治疗组糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平上调,微量白蛋白(MA)、β2-微球蛋白(β2-M)及肾脏损伤分子-1(KIM-1)水平下调,治疗组低于对照组差异有统计学意义(P<0.05)。2与治疗前相比,治疗组治疗后Vit D3水平上调,治疗组高于对照组差异有统计学意义(P<0.01)。3T2DM患者Vit D3水平与MA(r=-0.432),β2-M(r=-0.615),及KIM-1(r=-0.763)水平均呈负相关(P<0.05)。结论 Vit D3可有效减轻T2DM患者的早期肾损害,对肾脏具有保护作用。

Objective To observe the clinical effect of 25-hydroxy vitamin D3 （25 （OH）D3 ） on early renal damage in patients with type 2 diabetes mellitus （T2DM）. Methods Eighty patients with T2DM and early renal damage were equally randomly divided into the treatment group and the control group. The control group was treated with the original antidiabetic scheme, and the treatment group was treated with the original antidiabetic scheme and intramuscular injection of vitamin D3. Both the two groups were treated for 10 months, and then we e- valuated the clinical efficacy. Results Compared with before treatment, the expression levels of hemoglobin Alc （HbAlc）, total cholesterol （TC）, triglyceride （TG） and low density lipoproteins （LDL-C） were increased in the treatment group, while the expression levels of micro albumin （MA）, β2-microglobulin （β2-M） and kidney injury molecule-1 （KIM-1） were decreased in the treatment group. And these index in the treatment group was lower than those in the control group （ P d0. 05）. Compared with before treatment, the expression level of Vit D3 was increased in the treatment group, and it was higher in the treatment group than that in the control group （ P d0.01）. （~）The expression level of T2DM patientts Vit D3 were negatively correlated with MA （ r = -0. 432）, β2-M （ r = -0. 615） and KIM-1 （ r =-0. 763） （P d0.05）. Conclusion 25-hydroxy vitamin D3 can effectively re- duce T2DM patientrs early renal damage, which has a protective effect on the kidney.