碳酸司维拉姆对老年终末期肾病合并高磷酸血症患者TGF-β1/Smad通路的影响

doi:10.3969/j.issn.1671-7171.2023.08.023

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1191 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要【目的】探讨碳酸司维拉姆对老年终末期肾病(ESRD)合并高磷酸血症患者转化生长因子β1(TGF-β1)/丝/苏氨酸激酶受体(Smad)通路的影响。【方法】82例老年ESRD合并高磷酸血症患者,随机分为两组,每组41例。对照组采用碳酸钙治疗,观察组采用碳酸司维拉姆治疗。比较两组治疗前后血清全段甲状旁腺激素(iPTH)、血钙、血磷、血脂[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、肾功能[血肌酐(Scr)、尿素氮(BUN)]、TGF-β1、Smad 7水平及两组不良反应发生率。【结果】两组治疗后血钙、血磷、TG、TC、LDL-C、Scr、BUN水平较治疗前降低(P<0.05),且观察组治疗后上述指标的水平低于对照组(P<0.05)。两组治疗后iPTH、HDL-C水平与治疗前及两组之间比较,差异无统计学意义(P>0.05)。两组治疗后TGF-β1水平较治疗前降低(P<0.05),Smad 7水平较治疗前升高(P<0.05);观察组治疗后TGF-β1水平低于对照组(P<0.05),Smad 7高于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】碳酸司维拉姆治疗老年ESRD合并高磷酸血症患者的疗效显著,可通过抑制TGF-β1/Smad信号通路表达,降低血钙、血磷及血脂水平,且用药安全,值得推广。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	崔莹雪
	陈博婷
	张盼

关键词 ：肾功能衰竭,慢性/并发症, 高尿酸血症/并发症, 司维拉姆/药理学

Abstract：【Objective】To explore the effect of sevelamer carbonate on the transforming growth factor β1 (TGF-β1) / Smad pathway in elderly patients with end-stage renal disease (ESRD) complicated with hyperphosphatemia. 【Methods】Eighty-two elderly patients with ESRD and hyperphosphatemia were randomly divided into two groups,with 41 cases in each group. The control group was treated with calcium carbonate,while the observation group was treated with sevelamer carbonate. The levels of intact parathyroid hormone (iPTH),serum calcium ,serum phosphorus,lipid [total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C)],renal function [serum creatinine (Scr),blood urea nitrogen (BUN)] and TGF-β1,Smad,and the occurrence rate of adverse reactions were compared between the two groups before and after treatment. 【Results】After treatment,the levels of serum calcium ,serum phosphorus,TG,TC,LDL-C,Scr,and BUN in both groups were lower than those before treatment (P<0.05),and these indicators in the observation group were lower than those in the control group (P<0.05). There were no significant differences in the levels of iPTH,HDL-C before and after treatment between the two groups (P>0.05). The levels of TGF-β1 were lower and the levels of Smad 7 were higher after treatment in both groups (P<0.05). The level of TGF-β1 in the observation group was lower than that in the control group,and the level of Smad 7 was higher than that in the control group (P<0.05). There was no significant difference in the occurrence rate of adverse reactions between the two groups (P>0.05). 【Conclusion】Sevelamer carbonate has a significant therapeutic effect on elderly patients with ESRD complicated with hyperphosphatemia. It can inhibit the expression of the TGF-β1/Smad signaling pathway,reduce the levels of blood calcium,phosphorus,and lipids,and is safe for medication use,hence it is worth promoting.

Key words： Kidney Failure,Chronic/CO Hyperuricacidemia/CO Sevelamer/PD

收稿日期: 2022-06-20

中图分类号:

R692

通讯作者: ^*E-mail:13384994006@163.com

引用本文:

崔莹雪, 陈博婷, 张盼. 碳酸司维拉姆对老年终末期肾病合并高磷酸血症患者TGF-β1/Smad通路的影响[J]. 医学临床研究, 2023, 40(8): 1200-1203.
CUI Ying-xue, CHEN Bo-ting, ZHANG Pan. Effect of Sevelamer Carbonate on TGF-β1/Smad Pathway in Elderly Patients with End-stage Renal Disease and Hyperphosphatemia. JOURNAL OF CLINICAL RESEARCH, 2023, 40(8): 1200-1203.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.08.023 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I8/1200

[1] JORGE A,WALLACE Z S,ZHANG Y,et al. All-Cause and cause-specific mortality trends of end-stage renal disease due to lupus nephritis from 1995 to 2014[J].Arthritis Rheumatol,2019,71(3):403-410.
[2] SPOENDLIN J,PAIK J M,TSACOGIANIS T,et al. Cardiovascular outcomes of calcium-free vs calcium-based phosphate binders in patients 65 years or older with end-stage renal disease requiring hemodialysis[J].JAMA Intern Med,2019,179(6):741-749.
[3] ZHOU T,LI H,XIE W,et al. A meta-analysis of phosphate binders lanthanum carbonate versus sevelamer hydrochloride in patients with end-stage renal disease undergoing hemodialysis[J].Afr Health Sci,2018,18(3):689-696.
[4] HONG Q,ZHANG L,FU J,et al. LRG1 promotes diabetic kidney disease progression by enhancing TGF-β-Induced angiogenesis[J].J Am Soc Nephrol,2019,30(4):546-562.
[5] 王莉,李贵森,刘志红. 中华医学会肾脏病学分会《慢性肾脏病矿物质和骨异常诊治指导》[J].肾脏病与透析肾移植杂志,2013,22(6):554-559.
[6] KORATALA A,LAPPOT J M,KAZORY A . Radiographic manifestations of abnormal bone and mineral metabolism in end-stage renal disease[J].Clin Case Rep,2019,7(3):589-590.
[7] MA X,ZHANG Y,MA S,et al. Association between abnormal thalamic metabolites and sleep disturbance in patients with end-stage renal disease[J].Metab Brain Dis,2018,33(5):1641-1648.
[8] 汪四海,方朝晖,倪英群,等. 丹蛭降糖胶囊对糖尿病肾病大鼠肾脏TGF-β1/Smad3信号通路和AGEs/RAGE水平的影响[J].中华中医药杂志,2021,36(4):2019-2024.
[9] 李靖,曹参,吴勤研,等. 碳酸司维拉姆对终末期肾脏病并发高磷血症病人磷钙及低密度脂蛋白胆固醇水平的影响[J].安徽医药,2020,24(3):583-586.
[10] 张杏珍,林美丽. 司维拉姆联合依帕司他对糖尿病肾病血液透析患者炎症反应及钙磷代谢的影响[J].中国临床药学杂志,2020,29(6):402-405.
[11] 史永红,吴广礼. 维持性血液透析患者血管钙化的高危因素及治疗进展[J].解放军医药杂志,2020,32(7):112-116.
[12] 赵婷. TGF-β1/Smad信号通路与糖尿病肾病关系的研究进展[J].海南医学,2021,32(5):642-646.
[13] 汪绪祥,王锁刚. 移植肾纤维化与TGFβ1-Smad/p38MAPK信号通路的研究进展[J].南昌大学学报(医学版),2020,60(6):82-85.
[14] 牛丹,吕佳,王晓培,等. 司维拉姆治疗维持性透析患者高磷血症有效性和安全性观察[J].陕西医学杂志,2017,46(10):1455-1457.