目的：观察维生素D代谢物1，25-二羟维生素D3[1，25-（OH）2D3]对早期糖尿病肾病（DN）患者炎性因子TGF-β、TNF-α、IL-6、hs-CRP水平的影响。方法2型糖尿病患者150例，其中单纯糖尿病患者60例为DM组，早期DN 90例为DN组。 DN组再随机分为治疗亚组和对照亚组各45例。对照亚组常规治疗，治疗亚组常规治疗＋骨化三醇胶丸，疗程均3个月，比较各组1，25-（ OH）2 D3、24 h尿蛋白定量及相关炎性因子的变化。结果治疗前，DN组1，25-（OH）2D3水平低于DM组（ P ＜0．05）；TGF-β、TNF-α、IL-6、hs-CRP，24 h尿蛋白定量、SCr水平均高于DM组（ P ＜0．05）；治疗亚组治疗后TGF-β、TNF-α、IL-6、hs-CRP水平及24 h尿蛋白定量均较治疗前降低（ P ＜0．05），1，25-（OH）2D3水平较前升高（ P ＜0．05）。对照亚组与治疗亚组不良反应发生率比较差异无统计学意义（11．11％vs．11．11％， P ＞0．05）。结论早期DN患者1，25-（OH）2D3缺乏，炎性因子水平增高，补充骨化三醇胶丸可以改善炎性反应状态。%Objective To observe the effects of vitamin D metabolites 1,25-dihydroxy vitamin D3[1,25-(OH)2D3] on early diabetic nephropathy (DN) in patients with inflammatory factors TGF-β, TNF-α, IL-6, hs-CRP level.Methods 150 patients with type 2 diabetes, in which 60 patients with diabetes alone as the DM group , 90cases of early DN as DN group.DN group was randomly divided into sub-treatment group and sub-control group with each group of 45 cases.Control subgroup received conventional treatment , treatment subgroup received conventional therapy +calcitriol capsules , after 3 months of treatment 1,25-(OH)2D3,24 h urinary protein and related inflammatory factors changes were compared among groups.Results Before treatment, DN group's 1,25-(OH)2D3 levels lower than the DM group ( P <0.05);TGF-β, TNF-α, IL-6, hs-CRP, 24 h urinary protein, SCr levels were higher than the DM group ( P <0.05); after treatment, treatment subgroup's TGF-β, TNF-α, IL-6, hs-CRP levels and 24 h urinary protein quantitative lower than before treatment ( P <0.05),1,25-(OH)2D3 levels increased compared with the previous ( P <0.05).Poor control and treatment subgroup reac-tion rate difference was not statistically significant (11.11%vs.11.11%, P >0.05).Conclusion Early DN patients'1, 25-( OH) 2 D3 deficiency , levels of inflammatory cytokines increased , complement calcitriol capsules can improve inflammatory state.
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