前列腺素E_1对糖尿病肾病患者肾动脉血流动力学的影响

Effect of prostaglandin-E_1 on hemodynamics of renal arterial blood flow in patients with diabetic nephropathy

目的:了解前列腺素E1(PGE1)对糖尿病肾病(DN)患者肾动脉血流动力学的影响.方法:利用彩色多普勒观察95例DN患者经PGE1治疗前后的肾动脉血流动力学的变化.结果:DN患者肾动脉血流动力学的各项参数,特别是肾动脉内径、时间速度积分、阻力指数变化显著(P<0.01);PGE1治疗后,其各项参数均有明显的变化(P<0.05);同时BUN,Cr水平由治疗前的(10.1±5.4)mmol/L,(194±51)μmol/L降至(7.9±6.0)mmol/L,(99±35)μmol/L,尿量由(948±128)mL/d增至(1242±373)mL/d,均有明显的改善(P<0.05).结论:DN时多伴有凝血、纤溶障碍所导致的肾动脉血流动力学的变化,应用PGE1治疗有益于延缓肾功能的恶化.

AIM： To observe the effect of prostaglandin-E（ PGE1 ） on the hemedynamics of renal arterial blood flow in diabetic nephropathy （DN）. METHODS： The renal color Doppler ultrasound was employed to examine renal arterial blood flow before and after treatment with PGE1 in 95 DN patients and 88 normal controls. RESULTS： The hemodynamic parameters of renal arterial blood flow in DN patients, especially the inner diameter of renal artery, velocity time integral and resistent index, were significantly changed （ P 〈 0. 01 ） ; after treatment with PGE1 the parameters mentioned above were changed as well （P〈0.05） ;the levels of BUN and Cr increased from （10. 1 ±5.4） mmol/L, （ 194 ± 51 ）μmol/L before treatment to （ 7.9 ± 6.0） mmol/L, （99 ± 35 ） μmol/L after treatment, and the amount of urine increased from （948 ± 128） mL/d to （ 1242 ± 373 ） mL/d; the parameters of renal function were improved significantly （ P 〈 0.05 ）. CONCLUSION： The hemodynamics of renal arterial blood flow in DN patient was changed, which was caused by the coagulation disorders and fibrinolytic disorders. The application of PGE1 in the treatment of renal failure is beneficial to delay the deterioration of renal function.