强化代谢控制对2型糖尿病并肾脏疾病患者IL―6IL―18水平影响.docVIP

强化代谢控制对2型糖尿病并肾脏疾病患者IL―6IL―18水平影响 　　【摘要】目的观察强化代谢控制对2型糖尿病并肾脏疾病（Type 2 diabetic kidney disease，T2DKD）患者白细胞介素6（IL-6）、白细胞介素18（IL-18）的影响，探讨强化代谢控制对延缓DKD进展的作用。方法选择2013年1月至2015年12月在右江民族医学院附属医院住院的T2DKD Ⅲ～Ⅳ期患者120例，随机分成两组，常规治疗组（A组）及强化治疗组（B组），每组60例，分别给予常规治疗及强化治疗6个月，使用酶联免疫吸附法（ELISA）检测两组治疗前后血清IL-6、IL-18水平，同时检测糖化血红蛋白（HbA1c）、空腹血糖（FBG）、餐后2 h血糖（2 h PG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、甘油三酯（TG）、血压水平。结果综合代谢控制6个月后，常规治疗组收缩压（SBP）无明显变化（P005），两组其余各代谢、血压及炎症指标水平均明显下降（P005）。结论强化代谢控制可降低IL-6、IL-18水平，有利于延缓T2DKD进展。 　　【关键词】强化代谢控制；糖尿病肾脏疾病；白细胞介素6；白细胞介素18 　　中图分类号：R587.2文献标识码：ADOI：10.3969/j.issn.1003-1383.2017.06.004 　　【Abstract】ObjectiveTo observe the effect of intensive metabolic control on the levels of IL-6 and IL-18 in T2DKD（Type 2 diabetic kidney disease）patients，so as to investigate the effect of intensive metabolic control on delaying the progression of DKD.Methods120 patients with T2DKD stage Ⅲ to Ⅳ and hospitalized in Affiliated Hospital of Youjiang Medical University from January，2013 to December，2015 were selected.All patients were randomly divided into conventional treatment group（group A） and intensive treatment group（group B），with 60 cases in each group，and the two groups were given conventional treatment and intensive treatment for 6 months，respectively.Enzyme linked immunosorbent assay（ELISA）was used to detect the levels of serum IL-6 and IL-18 in the two groups before and after treatment.Meanwhile，glycosylated hemoglobin（HbA1c），fasting blood glucose（FBG），2 h postprandial blood glucose（2 h PG）total cholesterol（TC），low density lipoprotein（LDL-C），triglyceride（TG）and blood pressure levels were also detected.ResultsAfter 6 months of intensive metabolic control，the systolic blood pressure（SBP）did not change significantly in the conventional treatment group（P0.05），the levels of other metabolism，blood pressure and inflammatory indexes in the two groups significantly decreased（P0.05）.ConclusionIntensive metabolic control can reduce the levels of IL-6 and IL-18，which is beneficial to delay the pro