西洛他唑和前列腺素E1联合治疗对糖尿病肾病初期内皮素和一氧化氮的影响

The Effect of Endothelin(ET)and Nitrogen Monoxidum(NO) in the Treatment of Early Diabetic Nephropathy by Cilostazol and Prostaglandin E1

目的探讨西洛他唑和前列腺素E1联合治疗对糖尿病肾病初期内皮素(ET)和一氧化氮(NO)的影响。方法检测患者的一般临床指标及西洛他唑和前列腺素E1干预治疗1个月NO、ET、尿白蛋白排泄率(UAER)的变化。结果 UAER和ET:正常蛋白尿(NA)组、微量蛋白尿(MA)组逐渐升高,NO逐渐降低。MA组中UAER、ET和NO:西洛他唑组(B组)干预治疗后较治疗前升高,二者比较差异有统计学意义(P<0.05);前列腺素E1组(C组)治疗后较治疗前升高更明显,二者比较差异有统计学意义(P<0.01);联合治疗组(D组)治疗后较治疗前升高更显著,二者前后比较差异有统计学意义(P<0.01)。ET与UAER呈强正相关(rET=0.458,P<0.01);NO与UAER呈强负相关(rNO=-0.493,P<0.01)。结论西洛他唑和前列腺素E1治疗糖尿病肾病的疗效较肯定,并且联合治疗效果好于单药治疗。

Objective To study the effect of prostaglandin E1 and Cilostazol in the treatment of early diabetic nephropathy. Methods The changes in general clinie indexes were detected in patients with early diabetes nephropathy and urinary albumin excretion rate （UAER）,Endothelin （ET） and nitrogen monoxidum （NO） was detected before treatment of Cilostazol and prostaglandin E1 and after one month. Results The levels of UAER and ET were incre ased in microalbumimia group. The level of NO was decreased in microalbuminria group. After one month in treatment of Cilostazol and proslaglandin El therapy, the levels of UAER, ET and NO were changed. The levels of UAER and ET were decreased by Cilostazol or prostaglandin E1 （P 〈 0.05）and co-treatment（P 〈 0.01 ）. The level of NO was increased by Cilostazol or prostaglandin El （P 〈 0.05）and co-treatment（P 〈 0.01 ）.Endothelin and nitrogen monoxidum were related with urinary albumin excretion rate （rET =0.458,rNO =-0.493,P 〈 0.01 ）. Conclusion The therapy effect of prostaglandin El or Cilostazol was sure in early diabetic nephropathy, moreover, the effect of co-treatment with Cilostazol and prostaglandin E1 was better than single treatment.