目的分析2型糖尿病(T2DM)合并糖尿病周围神经病变(DPN)采取维生素D2注射液与硫辛酸注射液联合治疗的效果。方法选择90例T2DM合并DPN患者,依据随机数表分为对照组与研究组,每组45例。对照组以硫辛酸注射液实施治疗,研究组以维生素D2注射...目的分析2型糖尿病(T2DM)合并糖尿病周围神经病变(DPN)采取维生素D2注射液与硫辛酸注射液联合治疗的效果。方法选择90例T2DM合并DPN患者,依据随机数表分为对照组与研究组,每组45例。对照组以硫辛酸注射液实施治疗,研究组以维生素D2注射液与硫辛酸注射液共同治疗。对比两组患者的临床治疗效果、神经传导速度[正中神经感觉神经传导速度(MSCV)、腓总神经运动神经传导速度(PMCV)、正中神经运动神经传导速度(MMCV)、腓总神经感觉神经传导速度(PSCV)]、血糖指标[糖化血红蛋白(HbA1c)、餐后2 h血糖(2 h PG)、空腹血糖(FPG)]及不良反应发生情况。结果治疗后,研究组总有效率为95.56%,对照组总有效率为82.22%,两组相比研究组更优(P<0.05)。治疗后,研究组MSCV(59.17±3.23)m/s、PMCV(45.89±2.51)m/s、MMCV(46.24±2.24)m/s、PSCV(35.13±2.02)m/s均比对照组的(55.61±2.69)、(43.01±2.27)、(43.29±2.63)、(32.16±3.62)m/s高(P<0.05)。治疗后,研究组HbA1c(6.09±0.78)%、2 h PG(10.83±0.86)mmol/L、FPG(5.35±0.46)mmol/L与对照组的(7.01±0.84)%、(11.82±0.68)mmol/L、(6.96±0.71)mmol/L相比较低(P<0.05)。治疗后,研究组不良反应发生率4.44%与对照组的6.67%相比,差异无统计学意义(P>0.05)。结论T2DM合并DPN采取维生素D2注射液与硫辛酸注射液联合治疗的效果较好,能够使患者的血糖指标得到有效改善,使患者神经传导的速度加快,能有效促进其早日康复,临床上值得推广使用。展开更多
AIM To study the molecular effects of three different D-vitamins, vitamin D2, vitamin D3 and calcipotriol, in pancreatic stellate cells(PSCs).METHODS Quiescent PSCs were isolated from mouse pancreas and activated in v...AIM To study the molecular effects of three different D-vitamins, vitamin D2, vitamin D3 and calcipotriol, in pancreatic stellate cells(PSCs).METHODS Quiescent PSCs were isolated from mouse pancreas and activated in vitro by seeding on plastic surfaces. The cells were exposed to D-vitamins as primary cultures(early-activated PSCs) and upon re-culturing(fullyactivated cells). Exhibition of vitamin A-containing lipid droplets was visualized by oil-red staining. Expression of α-smooth muscle actin(α-SMA), a marker of PSC activation, was monitored by immunofluorescence and immunoblot analysis. The rate of DNA synthesis was quantified by 5-bromo-2'-deoxyuridine(Brd U) incorporation assays. Real-time PCR was employed to monitor gene expression, and protein levels of interleukin-6(IL-6) were measured by ELISA. Uptake of proline was determined using 18 F-proline.RESULTS Sustained culture of originally quiescent PSCs inducedcell proliferation, loss of lipid droplets and exhibition of stress fibers, indicating cell activation. When added to PSCs in primary culture, all three D-vitamins diminished expression of α-SMA(to 32%-39% of the level of control cells; P < 0.05) and increased the storage of lipids(scores from 1.97-2.15 on a scale from 0-3; controls: 1.49; P < 0.05). No such effects were observed when D-vitamins were added to fully-activated cells, while incorporation of Brd U remained unaffected under both experimental conditions. Treatment of re-cultured PSCs with D-vitamins was associated with lower expression of IL-6(-42% to-49%; P < 0.05; also confirmed at the protein level) and increased expression of the vitamin D receptor gene(209%-321% vs controls; P < 0.05). There was no effect of D-vitamins on the expression of transforming growth factor-β1 and collagen type 1(chain α1). The lowest uptake of proline, a main component of collagen, was observed in calcipotriol-treated PSCs.CONCLUSION The three D-vitamins inhibit, with similar efficiencies, activation of PSCs in vitro, but cannot reverse the phenotype once the cells are fully activated.展开更多
文摘目的分析2型糖尿病(T2DM)合并糖尿病周围神经病变(DPN)采取维生素D2注射液与硫辛酸注射液联合治疗的效果。方法选择90例T2DM合并DPN患者,依据随机数表分为对照组与研究组,每组45例。对照组以硫辛酸注射液实施治疗,研究组以维生素D2注射液与硫辛酸注射液共同治疗。对比两组患者的临床治疗效果、神经传导速度[正中神经感觉神经传导速度(MSCV)、腓总神经运动神经传导速度(PMCV)、正中神经运动神经传导速度(MMCV)、腓总神经感觉神经传导速度(PSCV)]、血糖指标[糖化血红蛋白(HbA1c)、餐后2 h血糖(2 h PG)、空腹血糖(FPG)]及不良反应发生情况。结果治疗后,研究组总有效率为95.56%,对照组总有效率为82.22%,两组相比研究组更优(P<0.05)。治疗后,研究组MSCV(59.17±3.23)m/s、PMCV(45.89±2.51)m/s、MMCV(46.24±2.24)m/s、PSCV(35.13±2.02)m/s均比对照组的(55.61±2.69)、(43.01±2.27)、(43.29±2.63)、(32.16±3.62)m/s高(P<0.05)。治疗后,研究组HbA1c(6.09±0.78)%、2 h PG(10.83±0.86)mmol/L、FPG(5.35±0.46)mmol/L与对照组的(7.01±0.84)%、(11.82±0.68)mmol/L、(6.96±0.71)mmol/L相比较低(P<0.05)。治疗后,研究组不良反应发生率4.44%与对照组的6.67%相比,差异无统计学意义(P>0.05)。结论T2DM合并DPN采取维生素D2注射液与硫辛酸注射液联合治疗的效果较好,能够使患者的血糖指标得到有效改善,使患者神经传导的速度加快,能有效促进其早日康复,临床上值得推广使用。
基金Supported by FORUN program of the Rostock University Medical Center
文摘AIM To study the molecular effects of three different D-vitamins, vitamin D2, vitamin D3 and calcipotriol, in pancreatic stellate cells(PSCs).METHODS Quiescent PSCs were isolated from mouse pancreas and activated in vitro by seeding on plastic surfaces. The cells were exposed to D-vitamins as primary cultures(early-activated PSCs) and upon re-culturing(fullyactivated cells). Exhibition of vitamin A-containing lipid droplets was visualized by oil-red staining. Expression of α-smooth muscle actin(α-SMA), a marker of PSC activation, was monitored by immunofluorescence and immunoblot analysis. The rate of DNA synthesis was quantified by 5-bromo-2'-deoxyuridine(Brd U) incorporation assays. Real-time PCR was employed to monitor gene expression, and protein levels of interleukin-6(IL-6) were measured by ELISA. Uptake of proline was determined using 18 F-proline.RESULTS Sustained culture of originally quiescent PSCs inducedcell proliferation, loss of lipid droplets and exhibition of stress fibers, indicating cell activation. When added to PSCs in primary culture, all three D-vitamins diminished expression of α-SMA(to 32%-39% of the level of control cells; P < 0.05) and increased the storage of lipids(scores from 1.97-2.15 on a scale from 0-3; controls: 1.49; P < 0.05). No such effects were observed when D-vitamins were added to fully-activated cells, while incorporation of Brd U remained unaffected under both experimental conditions. Treatment of re-cultured PSCs with D-vitamins was associated with lower expression of IL-6(-42% to-49%; P < 0.05; also confirmed at the protein level) and increased expression of the vitamin D receptor gene(209%-321% vs controls; P < 0.05). There was no effect of D-vitamins on the expression of transforming growth factor-β1 and collagen type 1(chain α1). The lowest uptake of proline, a main component of collagen, was observed in calcipotriol-treated PSCs.CONCLUSION The three D-vitamins inhibit, with similar efficiencies, activation of PSCs in vitro, but cannot reverse the phenotype once the cells are fully activated.
