前列地尔对糖尿病肾病尿清蛋白排泄率、血小板活化和血脂的影响

Effect of alprostadil on urinary albumin excretion rate,platelet activation and blood lipid in patients with diabetic nephropathy

目的 :观察静脉应用前列地尔对老年糖尿病肾病尿清蛋白排泄率、血小板活化和血脂的影响。方法 :老年糖尿病肾病 76例 ,男性 4 8例 ,女性 2 8例 ,分为治疗组 4 0例和对照组 36例 ,2组均行常规治疗控制血糖、血压和血脂。治疗组加用前列地尔10 μg ,iv ,gtt ,每日 1次 ,2组疗程均为 14d。结果 :治疗后 ,治疗组尿清蛋白排泄率、血小板活化水平均下降 ,与治疗前、与对照组比较 ,差异有非常显著意义 (P <0 .0 1)。血肌酐由治疗前 (14 3±s 16 ) μmol·L- 1下降到 (96± 10 ) μmol·L- 1(P <0 .0 1) ,血脂变化与对照组无差异。结论 :静脉短期使用前列地尔能减少尿清蛋白排泄率 ,降低血小板活化 ,抑制血细胞粘附 ,降低血肌酐水平。

AIM: To observe the effect of alprostadil on urinary albumin excretion rate(UAER),platelet activation and blood lipid in old patients with diabetic nephropathy. METHODS: Seventy-six old patients with diabetic nephropathy (M 48,F 28) were divided into two groups: the treatment group( n =40) and the control group ( n =36). Patients in both groups were routinely treated to control blood glucose,blood pressure and blood lipid. Patients in treatment group were treated with intravenous infusion of alprostadil 10 μg qd for 14 d. RESULTS: After treatment,UAER and platelet activation of treatment group were both significantly reduced compared with those of the control group. In treatment group,creatinine decreased from (143± s 16)μmol·L -1 to (96±10)μmol·L -1 ( P <0.01). There were no significant differences in changes of blood lipid between two groups( P >0.05). CONCLUSION: Short-term intravenous infusion of alprostadil may decrease UAER, platelet activation,inhibit adhesiveness of platelet and leucocyte,and reduce the level of creatinine.