摘要
目的研究骨化三醇联合坎地沙坦治疗早期糖尿病肾病(DN)的临床疗效,以及对血清抗衰老蛋白Klotho与脂肪因子Vaspin表达水平的影响。方法选取2016年1月-2018年1月中国人民解放军东部战区总医院收治的DN患者100例,采取随机数字表法分成观察组和对照组,每组50例。对照组给予坎地沙坦治疗,观察组给予骨化三醇联合坎地沙坦治疗。比较两组的临床疗效及治疗前后肾功能、血脂、肾间质纤维化指标,以及血清Klotho与Vaspin表达水平的差异。结果观察组治疗有效率为92%,对照组为76%,差异有统计学意义(P<0.05);治疗后两组的血肌酐(Scr)、血尿素氮(BUN)、尿白蛋白排泄率(UAER)、转化生长因子β1(TGF-β1)、血管内皮生长因子(VEGF)、血清同型半胱氨酸(Hcy)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)较治疗前降低,且观察组低于对照组(P<0.05);两组高密度脂蛋白(HDL)治疗前后比较,差异无统计学意义(P>0.05);两组血清Klotho与Vaspin水平均高于治疗前(P<0.05),且治疗后观察组血清Klotho与Vaspin水平较对照组的升高(P<0.05)。结论骨化三醇联合坎地沙坦治疗早期DN可提高临床疗效,同时对血清Klotho、Vaspin水平也有一定的提高作用。
Objective To explore the clinical efficacy of calcitriol combined with candesartan in the treatment of early diabetic nephropathy and the effect on the expression level of serum anti-aging protein Klotho and Vaspin.Methods A total of 100 patients with early diabetic nephropathy who visited our hospital from January 2016 to January 2018 were selected,and were randomly divided into observation group and control group by use random number table method,with 50 patients in each group.The control group was treated with candesartan and the observation group was treated with combination of calcitriol and candesartan.The clinical efficacy,renal function,blood lipid,renal interstitial fibrosis,and serum Klotho and Vaspin expression levels of the two groups were compared.Results After treatment,the clinical efficiency in the observation group was 92%higher than 76%in the control group,and the difference was statistically significant(P<0.05);levels of Scr,BUN,UAER,VEGF,TGF-β1,Hcy,TC,TG and LDL were decreased in both groups,and the observation group was lower than the control group(P<0.05);there was no statistically significant difference between the two groups before and after HDL treatment(P>0.05).After treatment,the serum Klotho and Vaspin content in two group increased(P<0.05),which in the observation group were higher than those in the control group(P<0.05).Conclusion The combination of calcitriol and candesartan in the treatment of early diabetic nephropathy can significantly improve clinical efficacy,improve renal function,blood lipid and reduce renal fibrosis,and also increase serum Klotho and Vaspin levels,which is worthy of clinical reference.
作者
黄敏
陈颖
成水芹
韩丽君
李靖
Min Huang;Ying Chen;Shui-qin Cheng;Li-jun Han;Jing Li(Department of Nephrology,General Hospital of Eastern Theater of the People's Liberation Army,Nanjing,Jiangsu 210000,China;Department of Drug,General Hospital of Eastern Theater of the People's Liberation Army,Nanjing,Jiangsu 210000,China)
出处
《中国现代医学杂志》
CAS
2020年第7期53-58,共6页
China Journal of Modern Medicine
