骨化三醇联合盐酸吡格列酮对早期糖尿病肾病患者相关指标的影响
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篇名: 骨化三醇联合盐酸吡格列酮对早期糖尿病肾病患者相关指标的影响
TITLE:
摘要: 目的:探讨骨化三醇联合盐酸吡格列酮对早期糖尿病肾病(DN)患者血脂、肾功能、炎症因子等指标的影响。方法: 120例早期DN患者随机均分为对照组、V组、P组和V+P组。对照组患者给予糖尿病饮食、适度运动,重组甘精胰岛素注射液控制血糖等常规治疗;V组患者在对照组治疗的基础上给予骨化三醇胶丸0.25 μg,口服,每日1次;P组患者在对照组治疗的基础上给予盐酸吡格列酮胶囊30 mg,口服,每日1次;V+P组患者在对照组治疗的基础上给予骨化三醇胶丸(用法用量同V组)+盐酸吡格列酮胶囊(用法用量同P组)。各组疗程均为3个月。观察各组患者治疗前后血脂[三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)]、肾功能[血肌酐(Scr)、血尿素氮(BUN)、尿白蛋白排泄率(UAER)]、炎症因子[C反应蛋白(CRP)、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6]水平及不良反应发生情况。结果:治疗前,各组患者血脂、肾功能、炎症因子水平比较,差异均无统计学意义(P>0.05)。治疗后,对照组患者TC、UAER,V组患者TC、LDL、IL-6、Scr、BUN、UAER,P组、V+P组患者TG、TC、LDL、Scr、BUN、UAER、CRP、TNF-α、IL-6均显著低于同组治疗前,V+P组患者TG、TC、LDL、Scr、BUN、UAER、CRP、TNF-α、IL-6及P组患者TG、Scr、CRP均显著低于对照组,而V+P组TG低于P组,差异均有统计学意义(P<0.05);各组患者HDL治疗前后比较,差异均无统计学意义(P>0.05)。各组患者治疗期间均未见明显不良反应发生。结论:在常规治疗的基础上,骨化三醇联合盐酸吡格列酮可显著降低早期DN患者血脂、改善肾功能及炎症状态,且安全性较好。
ABSTRACT: OBJECTIVE:To explore the effects of calcitriol combined with pioglitazone hydrochloride on the cholesterol, kidney functions and inflammatory cytokines of patients with early-stage diabetic nephropathy (DN). METHODS: 120 patients with early-stage DN were randomly divided into control group, group V, group P and group V+P. Control group was given diabetic diet, moderate exercise, Recombinant insulin glargine injection to control blood glucose and other conventional treatment; group V was additionally given 0.25 μg Calcitriol soft capsule, orally, qd; group P was additionally given 30 mg Pioglitazone hydrochloride granule, orally, qd; group V+P was additionally given Calcitriol soft capsule (the same dosage with group V)+Pioglitazone hydrochloride granule(the same dosage with group P). The treatment course for all groups was 3 months. serum lipids indexes [triglyceride (TG), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL)], renal function indexes [serum creatinine (Scr), blood urea nitrogen (BUN), UAER], inflammatory cytokines [C-reactive protein (CRP), tumor necrosis factor (TNF) -α, interleukin (IL) -6] before and after treatment, and the incidence of adverse reactions in all groups were observed. RESULTS: After treatment, there were no significant differences in the serum lipids indexes, renal function indexes and inflammatory cytokines among all groups(P>0.05). After treatment, TC and UAER in control group, TC, LDL, IL-6, Scr, BUN and UAER in group V, TG, TC, LDL, Scr, BUN, UAER, CRP, TNF-α and IL-6 in group P and group V+P were significantly lower than before, TG, TC, LDL, Scr, BUN, UAER, CRP, TNF-α and IL-6 in group V+P, TG, Scr and CRP in group P were significantly lower than control group, TG in group V+P was significantly lower than group P, the differences were statistically significant(P<0.05), and there were no significant differences in the HDL among all groups(P>0.05). There were no obvious adverse reactions during treatment. CONCLUSIONS: Based on the conventional treatment, calcitriol combined with pioglitazone hydrochloride can significantly reduce the cholesterol, improve renal function and inflammatory states of patients with early-stage DN, with good safety.
期刊: 2016年第27卷第9期
作者: 李艳红,黎艳,李莉,汪晓红,代丹娇
AUTHORS: LI Yanhong,LI Yan, LI Li,WANG Xiaohong,DAI Danjiao
关键字: 骨化三醇;盐酸吡格列酮;早期;糖尿病肾病
KEYWORDS: Calcitriol; Pioglitazone hydrochloride; Early-stage; Diabetic nephropathy
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