目的 了解兒童糖尿病腎病患者血清維生素D的變化，并探討維生素D對兒童糖尿病腎病發(fā)展的影響。方法 2015年6月-2018年2月從安陽地區(qū)醫(yī)院共篩選69例兒童作為研究對象，分為1型糖尿病腎病組、2型糖尿病組和對照組，采用酶聯(lián)免疫法測定25-羥基維生素D3[25（OH）D3]、甲狀旁腺激素（PTH），采用免疫化學(xué)發(fā)光測定胰島素（FINS）、C-肽（C-P）以及尿素氮（BUN）、肌酐（Scr）、尿微量白蛋白/肌酐比（ACR）。以25（OH）D3為因變量，分別以PTH、Ca、P、空腹血糖（FPG）、FINS、C-P、總膽固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）、ACR為自變量，進(jìn)行Pearson相關(guān)分析。結(jié)果 各組資料對象的性別、年齡差異無統(tǒng)計學(xué)意義；與對照組比較，1型糖尿病腎病組、2型糖尿病組FPG、FINS、C-P、ACR和25（OH）D3差異均有統(tǒng)計學(xué)意義（P<0.05）。25（OH）D3與FPG、ACR呈負(fù)相關(guān)，與FINS、C-P、Scr、BUN呈正相關(guān)（P<0.05）。結(jié)論 維生素D的減少促使兒童糖尿病的發(fā)生，參與了糖尿病腎病的發(fā)展，可能在1型糖尿病腎病的發(fā)病過程中起著重要作用。

Objective To study the changes of serum vitamin D levels in children with diabetic nephropathy, and explore the effect of vitamin D on the development of children with diabetic nephropathy. Methods Children (69 cases) in Anyang District Hospital from June 2016 to February 2018 were divided into type 1 diabetic nephropathy group, type 2 diabetes group, and control group. 25-Hydroxyvitamin D3[25(OH) D3] and parathyroid hormone (PTH) were determined by enzyme-linked immunoassay, and insulin (FINS), C-peptide (C-P), urea nitrogen (BUN), creatinine (Scr) and urinary microalbumin/creatinine ratio (ACR) were determined by immunochemilu-minometric assay. 25(OH) D3 was taken as the dependent variable, and PTH, CA, P, FPG, FINS, C-P, TC, TG, HDL-C, LDL-C, and ACR as the independent variables, and Pearson correlation analysis was carried out. Results The sex and age of children in three groups were no difference. Compared with the control group, there were significantly different in FPG, FINS, C-P, ACR, and 25 (OH) D3 in type 1 diabetic nephropathy group and type 2 diabetic group (P<0.05). 25(OH) D3 was negatively correlated with FPG and ACR, and positively correlated with FINS, C-P, SCR and Bun (P<0.05). Conclusion The decrease of vitamin D promotes the occurrence of diabetes in children's, participates the development of children with diabetic nephropathy, and vitamin D may play an important role in the pathogenesis of type 1 diabetic nephropathy.

R977

濮陽市科技計劃項(xiàng)目（160229）