摘要
目的分析维生素D3治疗糖尿病肾病(DN)患者肾组织足细胞损伤与活性氧(ROS)、晚期蛋白氧化产物(AOPP)及超氧化物歧化酶(SOD)的相关性。方法选择2017年3月-2019年1月内蒙古自治区人民医院肾内科诊治DN患者86例作为研究对象,根据患者尿清蛋白排泄率(UAER)水平分为大量组(UAER≥200μg/min,n=46)和微量组(20μg/min≤UAER<200μg/min,n=40)。所有患者经6周的洗脱期后,予骨化三醇0.25μg/d治疗3个月。比较2组患者治疗前后血清ROS、AOPP、SOD及尿足细胞标志蛋白(PCX)、足细胞裂孔膜蛋白(Nephrin)、肾脏组织内synaptopodin和WT-1表达水平的变化,并分析肾组织足细胞损伤与血清ROS、AOPP、SOD的相关性。结果与治疗前比较,2组患者治疗后血清ROS、AOPP水平,尿PCX、Nephrin水平及肾脏组织内synaptopodin、WT-1表达水平均明显降低,血清SOD明显升高;与大量组治疗后比较,微量组上述指标变化更为显著(t=9.631、6.544、18.729、7.386、25.410、8.602、4.703,P均<0.01)。经Pearson相关性分析,患者尿PCX、Nephrin及肾脏组织内synaptopodin、WT-1表达水平与血清ROS、AOPP均呈正相关,与血清SOD呈负相关(r/P=0.781/0.005、0.537/0.014,0.575/<0.001、0.684/0.015,0.654/0.035、0.537/0.014,0.374/0.023、0.456/<0.001,-0.368/<0.001,-0.543/<0.001,-0.741/<0.001,-0.344/<0.001)。结论维生素D3可以一定程度改善DN患者足细胞损伤及氧化应激状态,且DN患者足细胞损伤与血清ROS、AOPP水平呈正相关,与血清SOD水平呈负相关。
Objective To analyze the relationship between podocyte injury and ROS,AOPP and SOD in DN treated with vitamin D3.Methods From March 2017 to January 2019,86 patients with DN diagnosed and treated in the Department of Nephrology of Inner Mongolia People s Hospital were selected as the study objects.According to the level of UAER,the patients were divided into a large number of groups(UAER≥200 μg/min,n=46) and a small number of groups(20 μg/min≤UAER <200 μg/min,n=40).All patients were treated with 0.25 μg/D calcitriol for 3 months after 6 weeks of washout.The changes of serum ROS,AOPP,SOD,PCX,nephrin,synaptopodin and WT-1 in renal tissue were compared before and after treatment,and the correlation between podocyte injury and serum ROS,AOPP,SOD was analyzed.Results Compared with before treatment,the levels of ROS,AOPP,PCX,nephrin in urine,synaptopodin and WT-1 in kidney tissue of the two groups were significantly decreased,and the level of SOD in serum was significantly increased.Compared with a large number of groups,the changes of the above indexes in the micro group were more significant(r=0.781,0.537,0.575,0.684,0.654,0.537,0.374,0.456,-0.368,-0.543,-0.741,-0.344,P <0.05).Conclusion Vitamin D3 can improve podocyte damage and oxidative stress in DN patients to some extent,and podocyte damage in DN patients is positively correlated with serum ROS,AOPP level,and negatively correlated with serum SOD level.
作者
赵晔
于磊
王秀颖
董丽娜
Zhao Ye;Yu Lei;Wang Xiuying;Dong Lina(Department of Renal Medicine,People's Hospital of Inner Mongolia Autonomous Region,Hohhot 010000,China)
出处
《疑难病杂志》
CAS
2020年第1期36-40,共5页
Chinese Journal of Difficult and Complicated Cases
基金
内蒙古自治区自然科学基金项目(2018MS08008)~~
