骨化三醇胶丸对糖尿病肾病患者尿蛋白水平的影响

目的] 探讨骨化三醇胶丸对糖尿病肾病(DN)患者尿蛋白水平的影响.方法] 选取DN患者86例,随机分为两组,每组43例.对照组采用控制血压、血糖及血脂等基础治疗,观察组在上述治疗的基础上口服骨化三醇胶丸,治疗持续3个月.比较两组患者的治疗有效率及患者治疗前后的白蛋白排泄率(uAER)、血肌酐(SCr)和肾小球滤过率(eGFR)及尿蛋白/肌酐比值(UAlb/Cr)变化.结果] 两组患者治疗后的uAER、SCr及UAlb/Cr水平均较治疗前明显降低(P<0.05),但观察组治疗后降低更明显,其差异均有统计学意义(P<0.05);两组治疗前后eGFR比较差异无统计学意义(P<0.05).与治疗前相比,两组患者治疗后的收缩压(SBP)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)及低密度脂蛋白胆固醇(LDL-C)明显下降(P<0.05),1.25二羟基维生素D31,25(OH)2D3] 及高密度脂蛋白胆固醇(HDL-C)较治疗前明显上升(P<0.05);观察组治疗后的FPG、HbA1c明显低于对照组,1,25(OH)2D3显著高于对照组,其差异均有统计学意义(P<0.05).患者治疗后的1,25(OH)2D3水平与临床疗效、治疗后的uAER、UAlb/Cr及血压有显著相关性(P<0.05).观察组有效率为83.72%(36/43),显著高于对照组62.79%(27/43),其差异有统计学意义(X2=4.807,P<0.05).结论] 骨化三醇胶丸可有效改善DN患者的肾功能,并降低尿蛋白水平,值得临床推广应用.

Influence of Calcitriol Soft Capsules on Urine Protein of Patients with Diabetic Nephropathy

Objective]To study the influence of calcitriol soft capsules on urine protein of patients with diabetic nephropathy (DN).Methods]From January 2014 to April 2016, 86 patients with DN were chosen as study objects.All patients were divided into 2 groups: the control group and the study group.The 43 patients in the control group were treated with anti-hypertension/ hyperglycemia/ hyperlipidemia, while the 43 patients in the study group were treated with calcitriol soft capsules for 3 months in addition to anti-hypertension/ hyperglycemia/ hyperlipidemia.The effect rate, SCr, uAER, eGFR and UAlb/Cr were compared between two groups.Results]After treatment, the uAER, SCr and UAlb/Cr of patients in the two groups decreased significantly (P<0.05), but the levels in the study group showed more dramatic decrease (P<0.05).There was no significant change in eGFR before and after treatment in the two groups (P>0.05).Compared to before treatment, the systolic blood pressure (SBP), fasting blood glucose (FPG), glycosylated hemoglobin (HbA1c) and low density lipoprotein cholesterol (LDL-C) in two groups were significantly decreased (P<0.05), while 1,25(OH)2D3 and high density lipoprotein cholesterol (HDL-C) were significantly higher than those before treatment (P<0.05).After treatment, the levels of FPG and HbA1c were significantly lower in the study group than those in the control group (P<0.05), but the level of 1,25(OH)2D3 was significantly increased (P<0.05).The level of 1,25 (OH)2D3 after treatment was significantly correlated with clinical efficacy, uAER, UAlb / Cr and blood pressure (P<0.05).The effect rate of study group was 83.72%(36/43) compared to that of the control group, which was 62.79%(27/43);the difference had statistical significance (X2=4.807,P<0.05).Conclusion]Calcitriol soft capsules can help increase the kidney function of patients with DN, as well decrease the urine protein.