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[摘要]
目的 探討活性維生素D用于慢性腎臟疾病的治療效果。方法 檢索Ovide Medline、CINAHL、Embase、CochraneCentral Register of Controlled Trials、中國學術期刊全文數(shù)據(jù)庫(CNKI)、中國生物醫(yī)學文獻數(shù)據(jù)庫(CBM)、萬方數(shù)據(jù)庫(Wangfang)和維普中文科技期刊數(shù)據(jù)庫(VIP)等數(shù)據(jù)庫,收集活性維生素D用于慢性腎臟疾病治療的臨床隨機對照研究(RCT),檢索年限均為2005年1月—2018年6月。采用Revman 5.3軟件進行數(shù)據(jù)分析。結(jié)果 共納入18個RCTs,Jadad量表評分均≥2分。治療后試驗組超敏C-反應蛋白(hs-CRP)[MD=-1.10,95% CI(-1.72,-0.49),P<0.05]、白介素6(IL-6)[MD=-23.77, 95% CI(-38.32,-9.22), P<0.05]與腫瘤壞死因子-α(TNF-α)[MD=-120.28,95% CI(-177.02,-63.54),P<0.05]降低幅度均高于對照組,兩組比較差異顯著(P<0.05);試驗組血肌酐(SCr)、24h尿蛋白定量與血尿素氮(BUN)降低幅度均高于對照組(P<0.05)。試驗組血清甲狀旁腺激素水平[MD=-10.87,95% CI(-13.44,8.30),P<0.05]降低幅度高于對照組。結(jié)論 活性維生素D可降低CKD患者微炎癥,改善患者腎功能,預防繼發(fā)性甲狀旁腺功能亢進。
[Key word]
[Abstract]
Objective To investigate the therapeutic effect of active vitamin D on chronic kidney disease. Methods Electronic databases, including Ovide Medline, CINAHL, Embase, Cochrane Central Register of Controlled Trials, CNKI and wanfang were searched, Randomized controlled trials (RCTs) which met the inclusion criteria were collected, search period from January 2005 to June 2018. Indicators of inflammation, renal function, parathyroid hormone (PTH) were extracted. Data analysis was performed using Revman 5.3 software. Results A total of 15 18 clinical RCTs were included, of which the Jadad scale scores were ≥ 2 points. After treatment, the reduction of high-sensitivity C-reactive protein (hs-CRP)[MD=- 1.10, 95%CI(- 1.72, - - 0.49), P<0.05], interleukin-6 (IL-6)[MD=-23.77, 95%CI(-38.32, -9.22), P<0.05] and tumor necrosis factor- α (TNF- α)[MD=-120.28, 95%CI (-177.02, -63.54), P<0.05] in the experimental group were higher than those in the control group, and the difference between the two groups was significant (P<0.05). Reduction of 24 h urine protein and blood BUN in the experimental group were higher than the control group (P<0.05). The reduction of serum PTH[MD=-10.87, 95%CI(-13.44, 8.30), P<0.05] in the experimental group was higher than that in the control group. Conclusion Active vitamin D can reduce microinflammation in patients with CKD, improve renal function and prevent secondary hyperparathyroidism.
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