钙神经蛋白抑制剂对糖尿病肾病的治疗效果及对肾脏炎症调节作用的影响

The Therapeutic Effect of Calcineurin Inhibitor on Diabetic Nephropathy and Its Influence on the Regulation of Renal Inflammation

目的研究钙神经蛋白抑制剂对糖尿病肾病治疗效果及对肾脏炎症调节作用的影响。方法选取2018年10月~2019年10月我院诊治的94例糖尿病肾病患者为研究对象,采用随机数字表法分为对照组和观察组,各47例。对照组采用常规治疗及对症治疗,观察组在对照组基础上采用钙神经蛋白抑制剂治疗,比较两组临床治疗总有效率、空腹血糖(FBG)、肾功能指标[血肌酐(Scr)、尿素氮(BUN)、血清胱抑素C(Cys C)、尿24h肌酐清除率(24hCcr)]、炎症因子[尿肾小球转化因子β(TGF-β)、炎症小体(NLRP3)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、尿单核细胞趋化蛋白(MCP-1)]水平。结果观察组治疗总有效率为95.74%,高于对照组的85.11%,差异有统计学意义(P<0.05);治疗后,观察组FBG低于对照组,差异有统计学意义(P<0.05);观察组Scr、BUN、Cys C低于对照组,24hCcr高于对照组,差异有统计学意义(P<0.05);观察组尿TGF-β、NLRP3、IL-6、TNF-α、尿MCP-1低于对照组,差异有统计学意义(P<0.05);在治疗和观察期间,两组均未发生严重不良反应。结论钙神经蛋白抑制剂可提高糖尿病肾病治疗效果,改善肾功能指标,降低炎症因子水平,抑制肾炎症反应,减轻肾脏炎症调节作用,进一步促进肾功能恢复,且临床应用安全性良好。

Objective To study the effect of calcineurin inhibitor on the treatment of diabetic nephropathy and its influence on the regulation of renal inflammation.Methods 94 patients with diabetic nephropathy diagnosed and treated in our hospital from October 2018 to October 2019 were selected as the research objects.They were divided into control group and observation group by random number table method,with 47 cases in each group.The control group was treated with conventional and symptomatic treatment,and the observation group was treated with calcineurin inhibitors on the basis of the control group.The two groups were compared with the total effective rate of clinical treatment,fasting blood glucose(FBG),renal function indicators[serum creatinine(Scr),urea Nitrogen(BUN),serum cystatin C(Cys C),urine 24h creatinine clearance(24hCcr)],inflammatory factors[urinary glomerular transforming factor β(TGF-β),inflammasome(NLRP3),Interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),urinary monocyte chemoattractant protein(MCP-1)]levels.Results The total effective rate of treatment in the observation group was 95.74%,which was higher than 85.11% in the control group,the difference was statistically significant(P<0.05);After treatment,the FBG of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05);The Scr,BUN and Cys C of the observation group were lower than those of the control group,and the 24h Ccr was higher than the control group,the difference was statistically significant(P<0.05);The urine TGF-β,NLRP3,IL-6,TNF-α,and urine MCP-1 in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05);During the treatment and observation period,no serious adverse reactions occurred in the two groups.Conclusion Calneurin inhibitors can improve the therapeutic effect of diabetic nephropathy,improve renal function indexes,reduce the level of inflammatory factors,inhibit renal inflammation,reduce the regulation of renal inflammation,and further promote the recovery of renal function.It is safe for clinical application.