Résumé
Objective To investigate the clinical characterastics of uremia pruritus and the value of treatment by bacillus coagulans. Methods The clinical data of 312 patients with maintenance hemodialysis were collected. The incidence rate, clinical manifestation and correlation factors of uremia pruritus were analyzed. Then, 40 refractory pruritus patients were divides into 2 groups by random digits table, with 20 patients in each group. The patients in experiment group were treated by bacillus coagulans, and the patients in control group were given vitamin E. The relieve of pruritus in two groups was compared. Results In 312 patients, 158 patients didn′t have pruritus, 56 patients had mild pruritus, 68 patients had moderate pruritus , and 30 patients had severe pruritus. The levels of urea nitrogen, creatinine, calcium, ferroprotein in different degree of pruritus patients had no significant differences (P>0.05), but the levels of phosphorus, calcium-phosphorus product, immunoreactive parathyroid hormone (iPTH), C reactive protein (CRP), interleukin (IL)-1 and IL-6 increased with the severity of pruritus (P0.05). The levels of CRP, IL-1 and IL-6 after treatment in experiment group significantly decreased (P<0.05). The rate of pruritus was very high , and there was markedly positive correlation between pruritus and serium inorganic phosphorus、iPTH and CRP. Bacillus coagulans can alleviate pruritus. Conclusions On the basis of maintenance hemodialysis, bacillus coagulans can regulate the intestinal flora, alleviate inflammatory reaction, and help to release the symptom of pruritus.
Résumé
Objective To determine the changes in serum and urine vitamin D binding protein ( VDBP) concentrations in type 2 diabetes, and to explore the clinical significance. Methods The serum and urine VDBP concentrations in 102 healthy individuals and 106 type 2 diabetic patients were determined by ELISA. For analysis and comparison, 106 type 2 diabetic patients were divided into imperfect glycemic control subgroup and perfect glycemic control subgroup, microalbuminuria subgroup and normal albuminuria subgroup. Results The cut-off point of serum VDBP concentrations was 60. 6 μg/ ml and the cut-off point of the urine ratio of VDBP and creatinine was 7. 76 mg/ g, and both were determined according to the upper limit of 97. 5 % credit intervals in 110 healthy individuals. Serum VDBP concentration and the urine ratio of VDBP to creatinine in type 2 diabetic patients were significantly higher than those in the healthy individuals ( P < 0. 01 ), the imperfect glycemic control subgroup had higher serum VDBP concentrations and the urine ratio of VDBP to creatinine than those in the perfect glycemic control subgroup ( P <0. 05). The microalbuminuria subgroup had higher urine ratio of VDBP to creatinine than that in the normal albuminuria subgroup ( P<0. 01). Urine ratio of VDBP to creatinine in diagnosing early diabetic nephropathy had sensitivity of 96. 4 % , specificity of 68 % , and concordance of 83% . Conclusion Detection of serum VDBP levels has some reference value in understanding the state of diabetes. Combined determinations of urine ratio of VDBP to creatinine and ratio of albumin to creatinine have significant clinical value in the early diagnosis of diabetic nephropathy.