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| 骨化三醇联合钙剂对肾病综合征患儿Th17/Treg免疫及骨代谢的影响 |
| The effect of calcitriol combined with calcium supplements on Th17/Treg immunity and bone metabolism in children with nephrotic syndrome |
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| DOI：10.3969/j.issn.1006-7108.2024.12.008 |
| 中文关键词: 肾病综合征 骨化三醇 Th17/Treg 骨代谢 |
| 英文关键词:nephrotic syndrome calcitriol Th17/Treg bone metabolism |
| 基金项目:江西省卫生计生委科技计划（20187243） |
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| 中文摘要: |
| 目的 分析骨化三醇联合钙剂辅助治疗肾病综合征（NS）患儿的临床疗效及可能作用机制。方法 收集2020年1月至2021年9月接受治疗NS患儿63例临床资料，根据治疗方法分为观察组（32例）、对照组（31例）。所有患儿均给予常规糖皮质激素治疗及营养干预。对照组同时给予维生素D联合钙剂辅助治疗，观察组同时给予骨化三醇联合钙剂辅助治疗。治疗12个月，比较两组Th17/Treg细胞、血钙磷、骨代谢、临床疗效等指标。结果 观察组Th17、Th17/Treg低于对照组，Treg高于对照组（P<0.05）。观察组血钙、25-羟维生素D3[25(OH)D3]、白蛋白（ALB）高于对照，24 h-尿蛋白定量（24-UTP）低于对照组（P<0.05）。观察组骨钙素（BGP）高于对照组，甲状腺旁激素（PTH）、碱性磷酸酶（AKT）、Ⅰ型胶原氨基端延长肽（P1NP）、β-胶原特殊序列（β-CTX）低于对照组（P<0.05）。观察组完全及显著缓解率81.25 %高于对照组58.06 %（χ2=4.019, P<0.05）。结论 骨化三醇联合钙剂辅助治疗能够提高NS患儿临床疗效，可能与矫正Th17/Treg免疫失衡、改善血钙磷及骨代谢紊乱等因素有关。 |
| 英文摘要: |
| Objective To analyze the clinical efficacy and possible mechanism of Calcitriol combined with calcium in the adjuvant treatment of children with NS . Methods 63 children with NS from January 2020 to September 2021 were divided into observation group (32 cases) and control group (31 cases) . All patients were given routine glucocorticoid treatment and nutritional intervention. The control group was given vitamin D combinded with calcium therapy, the observation group was given Calcitriol combined with calcium therapy. 12 months after treatment, H17/Treg cells, serum calcium and phosphorus, bone metabolism and clinical efficacy were compared between two groups. Results The Th17 and Th17/Treg levels in the observation group were lower than those in the control group, while Treg levels were higher than those in the control group（P<0.05）. The observation group had higher levels of blood calcium, 25 hydroxyvitamin D3 [25- (OH) D3)], and albumin (ALB) than the control group, while 24-hour urinary protein quantification (24-UP) was lower than the control group（P<0.05）. The observation group had higher levels of BGP than the control group, while levels of PTH, AKT, P1NP, and β-CTX were lower than those in the control group (P<0.05).The complete and significant remission rate of the observation group was 81.25%, which was higher than that of the control group（58.06%, χ2=4.019, P<0.05）. Conclusion The combination of calcitriol and calcium supplements as adjuvant therapy can improve the clinical efficacy of NS in children, which may be related to correcting Th17/Treg immune imbalance, improving blood calcium, phosphorus, and bone metabolism disorders. |
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