慢性肾脏病患者活性维生素D3与颈动脉粥样硬化相关性研究.docVIP

慢性肾脏病患者活性维生素D3与颈动脉粥样硬化相关性研究 　　[摘要]目的 探讨慢性肾脏病（CKD）患者活性维生素D3、微炎症、颈动脉粥样硬化之间的关系，活性维生素D3是否可以改善颈动脉粥样硬化及可能的机制。方法 选择2014年7月～2015年7月在我院确诊为CKD的非透析患者96例，按肾小球滤过率（GFR）分为三组，A组为CKD3期，B组为CKD4期，C组为CKD5期，每组32例，每组予骨化三醇0.25 μg/d，疗程1年。三组治疗前后测定25羟维生素D3[25（OH）2D3]、超敏C反应蛋白（hs-CRP）、颈动脉中内膜厚度（IMT）。结果 三组治疗前25（OH）2D3下降、hs-CRP升高、IMT值下降，与CKD的进展相关，骨化三醇干预治疗后，hs-CRP、IMT值下降（P0.05），hs-CRP、IMT值下降程度与25（OH）2D3上升成正相关（P0.05）。结论 25（OH）2D3水平、微炎症状态是CKD患者的颈动脉粥样硬化的相关性因素，骨化三醇可通过改善患者的微炎症状态，进而改善颈动脉粥样硬化。 　　[关键词]慢性肾脏病；活性维生素D3；颈动脉粥样硬化；颈动脉中内膜厚度；微炎症 　　[中图分类号] R692 [文献标识码] A [文章编号] 1674-4721（2017）06（b）-0045-03 　　[Abstract]Objective To investigate the relationship between active vitamin D3，micro-inflammation and carotid atherosclerosis in patients with chronic kidney disease（CKD），and whether active vitamin D3 could improve carotid atherosclerosis and the possible mechanism.Methods 96 non-dialysis patients diagnosed as CKD in our hospital from July 2014 to July 2015 were divided into three groups according to the glomerular filtration rate （GFR），group A was CKD3 stage，group B was CKD4 stage，group C was CKD5 stage，and each group had 32 cases.Each group was given Calcitriol of 0.25 μg/d for 1 year.25 hydroxyvitamin D3 [25 （OH）2D3]，hypersensitivity C reactive protein （hs-CRP） and carotid intima-media thickness （IMT） before and after treatment in the three groups were measured.Results 25 （OH）2D3 was decreased，hs-CRP increased and IMT decreased before treatment in the three groups which was associated with the progress of CKD，then after Calcitriol treatment，hs-CRP and IMT decreased （P0.05）.The decrease degree of hs-CRP and IMT was positively correlated with the increase of 25 （OH）2D3 （P0.05）.Conclusion 5 （OH）2D3 level and micro-inflammatory status are the factors of carotid atherosclerosis in patients with CKD，Calcitriol can improve carotid atherosclerosis by improving the Micro inflammation. 　　[Key words]Chronic kidney disease；Active vitamin D3；Carotid atherosclerosis；Carotid intima-media thickness；Micro-inflammation