前列地尔联合替米沙坦对早期糖尿病肾病患者的超敏C反应蛋白及胱抑素的作用研究

The function of aiprostadil jointly for telmisartan on high sensitivity crp and cysc in patients with early diabetic nephropathy

目的研究前列地尔（前列腺素E1脂微球制剂）联合替米沙坦在治疗早期糖尿病肾病（DN）中对超敏C反应蛋白（hsCRP）及胱抑素（CysC）水平的影响。方法收集本院门诊和住院病人71例早期DN患者，随机分为单纯前列地尔组24例，单纯替米沙坦组23例，联合用药组24例，进行12周临床观察治疗，分别比较三组血压、血糖、糖化血红蛋白（HbA1 c）、尿微量白蛋白排泄率（UAER）、hsCRP及CysC水平的变化。结果三组在治疗前各项指标无明显差异（P〉0．05）；各组治疗12周后，UAER、hsCRP及CysC指标都较治疗前均有明显好转（P〈0．01）；而联合组的UAER、hsCRP及CysC较另两组改善更明显（P〈0．05）。结论前列地尔联合替米沙坦治疗早期DN，能有效改善hsCRP、CysC及减少UAER，并长期维持尿蛋白于低水平，有利于延缓甚至防止糖尿病肾病的发生和发展。

Objective To evaluate the The function of Alprostadil jointly for Telm isartan on High Sensitivity CRP and Cys C in patients with early diabetic nephropathy （ DN ）.Methods Seventy-one patients with early DN were randomly assigned to the pure Alprostadil group（n=24）treated on Alprostadi or the Telmisartan group（n=23）treated on telmisartan or the co-contractor group （ n=24 ） treated on Alprostadi and Telmisartan.for 1 2 weeks. Changes before and after treatment in levels of blood pressure, serHm lipids, plasma glucose, HbAlc, urine albumin excretion rate （ UAER ）, hsCRP and Cys- C were observed and compared between the three groups. Results The three groups showed similar levels of the indexes at baseline（P 〉 0.05）. After 12 weeks of treatment, UAER, hsCRP, Cys C were significantly improved in three groups （P 〈 0.01）. The combination group showed greater improvement in UAER, hsCRP and Cys C（P 〈 0.05）compared with the another controls. Conclusion Use of Alprostadil and telmisartan in the treatment of early diabetic nephropathy can decrease the levels ofhsCRP, Cys C and microalbuminuria, And the long-term maintenance urine protein in the low level, is advantageous to the postponement even prevents diabetes nephropathy the occurrence and the development.