摘要
目的探讨维生素D联合西格列汀对2型糖尿病肾病患者尿蛋白水平、骨密度和骨代谢的影响。方法选取2016年1月—2018年1月间宁波市鄞州区第二医院收治的114例2型糖尿病肾病患者,随机分为对照组56例和实验组58例。所有患者均给予降糖等常规治疗,在此基础上,对照组给予维生素D治疗,实验组给予维生素D联合西格列汀治疗,比较治疗后2组患者的尿白蛋白排泄率(UAER)、尿β_2-微球蛋白(β_2-MG)、24小时尿白蛋白、骨密度(L_2～L_4、股骨颈、Ward三角区、股骨粗隆区、髋关节)、血钙、血磷、25羟维生素D(25-OH-D_3)、甲状旁腺素(PTH)、骨钙素(BGP)、Ⅰ型前胶原氨基末端前肽(PINP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)。结果治疗后实验组患者的UAER、尿β_2-MG和24小时尿白蛋白水平均低于对照组(P<0.05);治疗后实验组患者各检测部位的骨密度均高于对照组(P<0.05);治疗后实验组的血钙高于对照组,血磷显著低于对照组(P<0.05);治疗后实验组的25-OH-D_3和PINP高于对照组(P<0.05),实验组的PTH、BGP和β-CTX低于对照组(P<0.05);对照组和实验组患者的不良反应总发生率分别为8.93%和12.07%(P=0.585)。结论在治疗2型糖尿病肾病中应用维生素D联合西格列汀能有效降低患者的尿蛋白,升高患者的骨密度并改善骨代谢,且安全性较好。
Objective To explore the effect of vitamin D combined with Siglitatin on urinary protein level,bone mineral density and bone metabolism in patients with type 2 diabetic nephropathy.Methods From January 2016 to January 2018,114 patients with type 2 diabetic nephropathy in our hospital were divided into two groups according to the random number table method,56 cases in the control group and 58 cases in the experimental group.All patients were given routine treatment such as hypoglycemia.On this basis,the control group was given vitamin D treatment,and the experimental group was given vitamin D combined with Siglitatin treatment.The urinary albumin excretion rate(UAER),urinary beta 2-microglobulin(beta 2-MG),urinary microalbumin(mA1 b),bone mineral density(L2-L4,femoral neck,Ward triangle,femoral trochanter,hip joint),serum calcium,phosphorus,25-hydroxyvitamin D(25-OH-D3),parathyroid hormone(PTH),bone gla protein(BGP),procollagen type I N propeptide(PINP)and C-terminal telopeptides of type I collagen(β-CTX)were compared between the two groups after treatment.Results After treatment,UAER,urinary beta 2-MG and 24-hour urinary albumin levels in the experimental group were lower than those in the control group(P<0.05).After treatment,the bone mineral density of each detection site in the experimental group was higher than that in the control group(P<0.05).The serum calcium of the experimental group were higher than those of the control group,and the serum phosphorus of the experimental group were lower than those of the control group(P<0.05).After treatment,the levels of 25-OH-D3 and PINP in the experimental group were significantly higher than those in the control group(P<0.05),and PTH,BGP and beta-CTX in the experimental group were significantly lower than those in the control group(P<0.05).The total incidence of adverse reactions in the control group and the experimental group were 8.93%and 12.07%,respectively,with no significant difference(P=0.585).Conclusion In the treatment of type 2 diabetic nephropathy,vitamin
作者
应一樱
陈洁
包蓓艳
YING Yi-ying;CHEN Jie;BAO Bei-yan(Department of Nephrology,the Second Hospital of Yinzhou District,Ningbo,Ningbo 315100,China)
出处
《中华全科医学》
2019年第5期797-800,840,共5页
Chinese Journal of General Practice
基金
浙江省医药卫生科技计划项目(2017ZD007)
关键词
维生素D
西格列汀
糖尿病肾病
骨代谢
尿蛋白
Vitamin D
Siglitatin
Diabetic nephropathy
Bone metabolism
Urinary protein
