前列地尔注射液联合谷红注射液治疗慢性肾衰竭临床疗效

Clinical Effects of Alprostadil Injection and Guhong Injection(谷红注射液)Treating Chronic Renal Failure

目的探讨对慢性肾衰竭患者联合采用谷红注射液和前列地尔注射治疗的临床疗效。方法研究纳入慢性肾衰竭患者86例,研究时间在2018年1月—2020年10月,按照随机分组的方式将86例患者分为对照组和观察组,每组各43例。两组患者均给予常规治疗措施,其中观察组在常规治疗基础上联合前列地尔和谷红注射液进行治疗,观察两组患者治疗前后肾功能指标、血脂指标、免疫学指标以及肝功能指标间的差异,比较两组患者治疗的安全性。结果观察组治疗前肾功能指标包含尿素氮(BUN)、血清肌酐(SCr)、内生肌酐(Ccr)和24h尿蛋白定量四项肾功能指标水平与对照组比较,差异无统计学意义(P>0.05);两组治疗后BUN、SCr和24h蛋白定量水平较本组治疗前均有明显下降,Ccr水平较本组治疗前有明显提高,两组组内比较差异具有统计学意义(P<0.05);观察组治疗后BUN、SCr和24h蛋白定量三项肾功能指标低于对照组,Ccr水平高于对照组,两组间比较差异具有统计学意义(P<0.05)。观察组和对照组无论是治疗前还是治疗后丙氨酸氨基转移酶(ALT)以及天门冬氨酸氨基转移酶(AST)两项肝功能指标比较差异均无统计学意义(P>0.05)。观察组治疗前循环免疫复合物(CIC)、CD^(+)_(3)、CD^(+)_(4)、CD^(+)_(8)和CD^(+)_(4)/CD^(+)_(8)五项免疫学指标水平比较差异无统计学意义(P>0.05);两组治疗后CIC和CD^(+)_(8)水平较本组治疗前均有明显下降,而CD^(+)_(3)、CD^(+)_(4)和CD^(+)_(4)/CD^(+)_(8)水平较本组治疗前均有明显提高,两组组内比较差异具有统计学意义(P<0.05);观察组治疗后CIC和CD^(+)_(8)两项免疫学指标水平低于对照组,CD^(+)_(3)、CD^(+)_(4)和CD^(+)_(4)/CD^(+)_(8)三项免疫学指标水平高于对照组,两组间比较差异具有统计学意义(P<0.05)。观察组治疗前总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)、载脂蛋白-B100(Apo-B100)和载脂蛋白-A1(Apo-A1)五项血脂指标水平与对照组比较差异无统计学意义(P>0.05);两组治疗后TC、TG和Apo-B100水平较本组治疗前均有明显下降,HDL-C和Apo-A1水平较本组治疗前均有明显升高,两组组内比较差异具有统计学意义(P<0.05);观察组治疗后TC、TG和Apo-B100三项血脂指标水平低于对照组,HDL-C和Apo-A1两项血脂指标水平高于对照组,两组间比较差异具有统计学意义(P<0.05)。观察组和对照组不良反应发生率18.60%(8/43)和13.95%(6/43)比较差异无统计学意义(P>0.05)。结论对慢性肾衰竭患者联合采用谷红注射液和前列地尔注射治疗不仅可以改善患者的肾功能,还可以降低机体的血脂,调节机体的免疫功能,并且不会对患者的肝功能造成影响,临床治疗的安全性较高。

Objective To discuss the clinical effects of alprostadil injection and Guhong Injection(谷红注射液)treating the chronic renal failure(CRF).Methods Eighty-six CRF patients treated from January 2018 to October 2020 in the hospital were selected.Patients were randomly divided into control group(43 cases)and observation group(43 cases).Both two groups took the routine treatment.Besides,the observation group took alprostadil injection and Guhong Injection.The renal function,blood lipid,immune function and hepatic function indicators and treatment safety were compared.Results Before treatment,there were no significant differences between two groups about the renal function indicators like blood urea nitrogen(BUN),serum creatinine(SCr),creatinine(Ccr)and 24-hour urine protein quantitation(P>0.05).After treatment,the levels of BUN,SCr and 24-hour urine protein quantitation for two groups were significantly lower.The Ccr levels of two groups were significantly higher(P<0.05).After treatment,the levels of BUN,SCr and 24-hour urine protein quantitation in the observation group were significantly lower than those of the control group.The Ccr level was significantly higher than that of the control group(P<0.05).There were no significant differences between two groups about alanine aminotransferase(ALT)and aspartate aminotransferase(AST)(P>0.05)before and after treatment.Before treatment,there were no significant differences between two groups about the circulating values of immune complex(CIC),of CD^(+)_(3),CD^(+)_(4),CD^(+)_(8)and CD^(+)_(4)/CD^(+)_(8)(P>0.05).After treatment,values of CIC and CD^(+)_(8)of two groups were significantly lower than those before treatment.The values of CD^(+)_(3),CD^(+)_(4)and CD^(+)_(4)/CD^(+)_(8)of two groups were significantly higher than those before treatment(P<0.05).After treatment,values of CIC and CD^(+)_(8)in the observation group were significantly lower than those in the control group.The values of CD^(+)_(3),CD^(+)_(4)and CD^(+)_(4)/CD^(+)_(8)in the observation group were significantly higher than those of the control group(P<0.05).Before treatment,there were no significant differences between two groups about levels of total cholesterol(TC),triglyceride(TG),high-density lipoprotein-cholesterol(HDL-C),apoprotein-B100(Apo-B100)or apoprotein-A1(Apo-A1)(P>0.05).After treatment,the contents of TC,TG and Apo-B100 of two groups were significantly lower than those before treatment.The contents of HDL-C and Apo-A1 of two groups were significantly higher than those before treatment(P<0.05).The contents of TC,TG and Apo-B100 in the observation group were significantly lower than those of the control group.The contents of HDL-C and Apo-A1 were significantly higher than those of the control group(P<0.05).The adverse event rate in the observation group(18.6%)was not significantly different compared with that(13.95%)of the control group(P>0.05).Conclusion Guhong Injection and alprostadil injection can reduce the blood lipid,produce less impact on the hepatic function,and improve the renal function,immune function and treatment safety for CRF patients.