摘要
目的观察骨化三醇联合福辛普利治疗2型糖尿病肾病蛋白尿的疗效并研究其可能的机制。方法将60例临床蛋白尿期的(24h尿蛋白≥1g)2型糖尿病肾病患者随机分为2组:对照组服用福辛普利10mg,1次/d,治疗组服用福辛普利10mg,1次/d,以及骨化三醇0.25μg,1次/d。每组30例,观察4周,比较治疗前后患者24h尿蛋白、尿微量白蛋白以及外周血T细胞亚群的变化。结果治疗4周后治疗组与对照组相比,24h尿蛋白、尿微量白蛋白出现下降,并且有统计学差异(P<0.05);并且外周血CD3+T细胞明显升高(P<0.05),CD4+T细胞明显降低(P<0.05),CD8+T细胞明显升高(P<0.05),CD4+/CD8+比值明显降低(P<0.05)。结论骨化三醇联合福辛普利能有效减少2型糖尿病肾病患者蛋白尿,可能通过免疫调节机制发挥作用。
Objective To observe the clinical therapeutic effects of calcitriol combined with fosinopril on type 2 diabetic nephropathy(DN) and to investigate the possible mechanism. Methods Sixty patients with type 2 DN with proteinuria more than 1 g/24 h were randomly divided into two groups: control group (n=30),treated with fosinopril 10 mg/d for 4 weeks, treatment group (n=30), treated with fosinopril 10 mg/d and calcitriol 0.25 μg/d for 4 weeks. Before and after treatment all patients received the measurement of 24 h urine protein, urine albumin, and peripheral blood T cell subsets changes. Results After 4 weeks of treatment, compared with the control group, the level of 24 h urinary protein, urinary albumin decline, CD4+T cells and CD4+/CD8+ were significantly decreased(P<0.05), and the level of peripheral blood CD3+T cells and CD8+T cells were significantly increased (P<0.05) in the treatment group. Conclusions Calcitriol combined with fosinopril can effectively reduce the level of proteinuria in the patients with type 2 DN, and may play a role through immunomodulatory mechanisms.
出处
《实用老年医学》
CAS
2013年第2期119-122,共4页
Practical Geriatrics
关键词
骨化三醇
福辛普利
型糖尿病肾病
蛋白尿
免疫调节
calcitriol
fosinopril
type 2 diabetic nephropathy
proteinuria
immunomodulatory
