摘要
目的:探讨慢性肾脏病(CKD)1~4期患者血清1,25(OH)2D水平与蛋白尿、尿炎症细胞因子的关系。方法:对我科115例CKD1~4期患者及20例健康对照者进行血清1,25(OH)2D、血CRP,尿TGF-β1、MCP-1、TNF、IL-6,24h尿蛋白定量检测;分析血清1,25(OH)2D水平与以上指标相关性。结果:(1)CKD组患者血清1,25(OH)2D水平低于对照组(P<0.05);血CRP,尿MCP-1、TGF-β1、IL-6、TNF水平,24h尿蛋白定量高于对照组(P<0.05)。(2)与GFR≥60ml.min-1.1.73m-2患者比较:GFR<44ml.min-1.1.73m-2患者CRP,尿MCP-1、TGF-β1、IL-6、TNF水平、24h尿蛋白定量升高(P<0.05);血清1,25(OH)2D水平降低(P<0.05);而GFR45~59ml.min-1.1.73m-2患者与GFR≥60ml.min-1.1.73m-2患者比较,两组间差异无统计学意义(P>0.05);(3)单因素相关分析显示CKD患者血清1,25(OH)2D与年龄(r=-0.442)、收缩压(r=-0.464)、舒张压(r=-0.399)、GFR(r=0.902)、Scr(r=-0.430)、PTH(r=-0.341)、UA(r=0.237)、24h尿蛋白定量(r=-0.372)及尿TGF-β1(r=-0.894)、MCP-1(r=-0867)、TNF(r=-0.899)、IL-6(r=-0.934)水平相关(P<0.05)。多元回归分析显示血清1,25(OH)2D与GFR呈正相关;与24h尿蛋白定量,尿MCP-1、IL-6,血Scr、PTH呈负相关。结论:CKD1~4期患者存在1,25(OH)2D水平降低,并与蛋白尿及尿炎症细胞因子水平密切相关。
Objective:To study the relationship between serum 1,25(OH)2D levels and albuminuria and urinary inflammatory cytokines in chronic kidney disease(CKD)patients.Methods:Clinical and laboratory data of 115 hospitalized CKD patients and 20 healthy hospital staff as control group were collected.serum 1,25(OH)2D,urinary TGF-β1,MCP-1,TNF,IL-6 levels and the relationship between serum 1,25(OH)2D and these clinical parameters were analysed.Results:(1)The mean levels of,blood pressure,BUN,Scr,serum phosphorus,PTH,24h urinary protein,CRP,TC,TG,LDL,UA,urinary MCP-1,urinary TGF-β1,urinary IL-6,urinary TNF of CKD patients were higher than that of control group,and the mean levels of GFR,serum calcium,HDL,serum 1,25(OH)2D levels were lower than control group(P〈0.05).(2)Compared with patients of GFR ≥60 ml·min^-1·1.73 m^-2,Serum CRP,The mean levels of urinary TGF-β1,MCP-1,IL-6,TNF and 24 h urinary protein of patients with GFR44 ml·min^-1·1.73 m^-2,were higher(P〈0.05),serum 1,25(OH)2D was decreased(P〈0.05),but those difference were not significantly between patients with GFR ≥60 ml·min^-1·1.73 m^-2 and 45-59 ml·min^-1·1.73 m^-2(P〈0.05).(3)The levels of serum 1,25(OH)2D of CKD patients were related with age(r=-0.442),systolic blood pressure(r=-0.464),diastolic blood pressure(r =-0.399),GFR(r=0.902),Scr(r=-0.430),PTH(r=-0.341),UA(r=0.237),24 h urinary protein(r=-0.372)and urinary TGF-β1(r=-0.894),MCP-1(r =-0867),TNF(r=-0.899),IL-6(r=-0.934)(P〈0.05).(4)The levels of serum 1,25(OH)2D of CKD patients were positively correlated with GFR and negative correlated with PTH and 24 h urinary protein urinary TGF-β1,MCP-1,TNF,IL-6.Conclusion:The levels of serum 1,25(OH)2D of CKD patients were closely correlated with proteinuria and the levels of urinary inflammatory cytokines.
出处
《中国中西医结合肾病杂志》
2011年第4期311-314,共4页
Chinese Journal of Integrated Traditional and Western Nephrology