慢性肾脏病(CKD)是全球性公共卫生问题,其发病率高、知晓率低,且与多种因素相关。近年来,大气颗粒物(PM)作为环境因素之一,与CKD的关联性受到广泛关注。该综述旨在探讨不同粒径的大气PM (包括PM10、PM2.5和PM1)对CKD发病风险的影响,并分析其潜在的生物学机制。研究表明,长期暴露于大气PM与CKD的发病率和进展风险增加有关。PM可能通过氧化应激、炎症反应、免疫反应、细胞自噬与凋亡以及血流动力学改变等途径影响肾脏功能。此外,PM中特定化学组分对肾脏的损害作用亦不容忽视。因此,该综述强调了制定有效的PM干预政策对于预防和控制CKD的重要性,并为未来的研究方向提供了新的视角。Chronic kidney disease (CKD) is a prevalent global public health concern characterized by high incidence rates, low awareness levels, and a multitude of associated factors. Recently, the correlation between atmospheric particulate matter (PM), as one of the environmental factors, and CKD has garnered substantial attention. This review aims to investigate the impacts of atmospheric PM of varying particle sizes, including PM10, PM2.5, and PM1, on the susceptibility to CKD and delve into the potential biological mechanisms. Findings indicate that long-term exposure to atmospheric PM is linked to a heightened incidence and risk of progression of CKD. PM may affect renal function via pathways involving oxidative stress, inflammation, immune response, cellular autophagy and apoptosis, and hemodynamic changes. Furthermore, the detrimental effects of specific chemical components within PM on kidney health should be considered. Consequently, this review highlights the necessity of implementing effective PM intervention policies for the prevention and control of CKD, thereby offering novel research avenues for exploration in the future.
目的探讨达格列净治疗老年肾病综合征(NS)伴发类固醇糖尿病(SDM)的效果。方法选取NS伴SDM患者110例,随机分为观察组与对照组,各55例。对照组采用舒洛地特常规治疗,观察组给予舒洛地特+达格列净治疗,均治疗3个月。对比观察两组治疗有效率、治疗前后肾功能、血糖、血脂指标及血清炎性因子的变化。结果观察组总有效率显著高于对照组(P<0.05)。两组治疗后血肌酐(SCr)、血尿素氮(BUN)、血清β2微球蛋白(β2-MG)、空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高敏C反应蛋白(hs-CRP)、白细胞介素(IL)-6、同型半胱氨酸(Hcy)均较治疗前下降,血清白蛋白(ALB)较治疗前升高,差异显著(P<0.05)。治疗后观察组SCr、BUN、β2-MG、FBG、2 h PG、HbA1c、hs-CRP、IL-6、Hcy、TC、TG、LDL-C低于对照组,ALB高于对照组,差异显著(P<0.05)。结论达格列净在舒洛地特治疗老年NS伴SDM患者的基础上可提高治疗效果、更好地改善肾功能、控制血糖及改善代谢状态,安全性较高。
