摘要
目的观察维生素D (Vit D)对有下尿路症状(LUTS)的老年男性患者血清过氧化物酶体增殖剂激活受体γ(PPAR-γ)及炎性因子的影响。方法选择2016年11月-2019年5月在医院门诊及住院的年龄>65岁的男性74例,按有无LUTS症状将患者分为LUTS组和非LUTS组,LUTS组36例给予Vit D治疗,400 IU/d。第6、12个月监测血清25羟基维生素D[25(OH)D]水平,收集前列腺超声结果、国际前列腺症状评分(IPSS)和生活质量(QOL)评分、炎性因子水平,ELISA检测血清PPAR-γ水平,记录终点事件。比较治疗前后相关指标变化情况。结果 LUTS组血清25(OH)D水平较非LUTS组低,同时炎性指标白介素-6(IL-6)、IL-8、C-反应蛋白(CRP)均较高(P <0.05);且LUTS组前列腺体积(PV)大,IPSS、QOL分值高,血清PPAR-γ水平降低(P <0.05)。服用Vit D后患者血清25(OH)D水平明显升高,12个月升高更显著,同时IPSS分值降低(P <0.05), QOL分值有降低趋势。炎症因子IL-6、IL-8、CRP均有所降低,IL-8在12个月降低更显著(P <0.05)。血清PPAR-γ水平随着治疗时间延长而升高,治疗6个月升高幅度最显著(P <0.05)。结论炎性因子参与LUTS的发生,维生素D可改善LUTS患者的尿路症状,其机制可能通过升高血清PPAR-γ水平,而达到抑制炎性因子的作用。
Objective To observe the effects of vitamin D(Vit D) on serum peroxisome proliferator-activated receptor gamma(PPAR-γ) and inflammatory factors in male elderly patients with lower urinary tract symptoms(LUTS). Methods A total of 74 male outpatients and inpatients aged over 65 years in our hospital from November 2016 to May 2019 were selected and divided into LUTS group and non-LUTS group based on the presence of LUTS. In the LUTS group, 36 patients were treated with Vit D at 400 IU/d. At six months and 12 months, serum 25-hydroxyvitamin D(25(OH)D) levels were monitored, and prostate volume(PV) with ultrasound,score of international prostate symptom score(IPSS), quality of life(QOL) score, and levels of inflammatory factors were collected. The serum PPAR-γ levels were detected using ELISA and the end-point events were recorded. The changes of related indexes before and after the treatment were compared. Results The serum 25(OH)D level in the LUTS group was lower than that in the non-LUTS group,and the inflammatory indexes of interleukin-6(IL-6), IL-8, and C-reactive protein(CRP) were higher(P < 0.05). The PV of the LUTS group was larger, the IPSS and QOL scores were higher, and serum PPAR-γ levels were decreased(P < 0.05). The serum 25(OH)D level of the patients administered Vit D was significantly increased, with more significant elevation at 12 months. Meanwhile, the IPSS score of the patients administered Vit D was reduced(P < 0.05), and the QOL score showed a downward trend. The levels of IL-6,IL-8 and CRP were lowered, and IL-8 decreased more significantly at 12 months(P < 0.05). The serum PPAR-γ level increased with the course of treatment, which showed a most significant elevation at six months after treatment(P < 0.05). Conclusion Inflammatory factors are involved in the development of LUTS. Vit D can improve the urinary tract symptoms of patients with LUTS, which may be realized by the mechanism that inhibiting the inflammatory factors with elevated level of serum PPAR-γ.
作者
许婷媛
张汝
徐贤华
Xu Tingyuan;Zhang Ru;Xu Xianhua(Ward of Cadre,General Hospital of Western Theater Command of PLA,Chengdu,Sichuan,610083,China)
出处
《西南国防医药》
CAS
2020年第11期999-1002,共4页
Medical Journal of National Defending Forces in Southwest China
基金
2016年四川省卫计委课题(16PJ017)。
