1,25二羟维生素D3治疗糖尿病肾病的临床研究

Clinical study of 1,25 dihydroxy vitamin D3 fordiabetic nephropathy

目的探讨1,25二羟维生素D3治疗糖尿病肾病的临床疗效。方法对124例符合诊断标准的糖尿病肾病患者进行随机分组,对照组在常规降糖、降压治疗时服用厄贝沙坦片75 mg/d,1次/d,早饭前口服;实验组在对照组基础上给予骨化三醇软胶囊1.0μg/次,1次/d,睡前口服。两组总疗程为12周。比较治疗4、8、12周两组患者生化指标及C反应蛋白(CRP)、转化生长因子β1(TGF-β1)、同型半胱氨酸(Hcy)变化,并对两组疗效进行比较。结果经治疗4周后,两组患者的24 h尿蛋白、三酰甘油(TG)、总胆固醇(TC)、肌酐(Scr)和尿素氮(BUN)的差异均具有统计学意义,实验组各指标降低更明显(P<0.05),而经治疗12周后,两组患者的Scr和BUN水平相比无统计学差异(P>0.05)。经治疗4周后,实验组患者的CRP、TGF-β1、Hcy水平显著低于对照组,差异具有统计学意义(P<0.05);两组疗效比较,实验组的有效率(93.55%)显著高于对照组的有效率(80.65%)(P<0.05)。结论1,25二羟维生素D3能够显著降低机体TGF-β1表达水平,降低对机体的炎症损伤,提高糖尿病肾病临床治疗效果。

Objective To investigate the clinical effect of 1,25 dihydroxyvitamin D3 in the treatment of diabetic nephropathy. Methods One hundred and twenty four patients were randomly divided into two groups,control group were given irbesartan tablets 75 mg / d,1 times / d,orally before breakfast within the conventional hypoglycemic and antihypertensive therapy; the experimental group was given irbesartan tablets and Calcitriol soft capsule 1. 0 μg / times,1 times / d,orally at bedtime,12 weeks for a course,compared biochemical indexes and the changes of CRP,TGF- beta 1,Hcy and the clinical effect in 4,8,12 weeks after treatment. Results The biochemical indexes analysis showed,in 4weeks after treatment urinary protein for 24 h,TG,TC,Scr and BUN were statistically different（ P〈0. 05）,After 12 weeks of treatment,there was no statistical difference in the levels of Scr and BUN between the two groups（ P〉0. 05）. The CRP,TGF- β1,Hcy levels of two groups of patients were statistically significant（ P〈0. 05）. For the efficacy,the experimental group（ 93. 55%） was greater than（ 80. 65%） that in the control group（ P〈0. 05）. Conclusion 1,25 dihydroxy vitamin D3 can significantly reduce the level of TGF- β1,reduce inflammatory damageand improve the clinical therapeutic effect of DN.