前列地尔治疗糖尿病肾病的时相性观察

Observation for effect of alprostadil on uric albumin excretion of the patients with diabetic nephropathy

目的:探讨前列地尔对2型糖尿病肾病患者蛋白尿及血黏度的影响及其随时间的变化情况。方法:选择48例2型糖尿病肾病患者,随机分成两组,给予糖尿病饮食、控制血压、血糖及慢性肾功能不全一体化治疗。治疗组每日给予前列地尔10μg,生理盐水100 mL静滴,连续3周。对照组给予黄芪30 mL/d静滴。观察治疗前、后,第1、3、6、9、12月后,尿白蛋白、血黏度等指标的变化。结果:两组治疗前后相比尿蛋白、血黏度均有显著下降(P<0.05);前列地尔组治疗后尿蛋白明显低于对照组(P<0.05),随着时间的进展,这种差距逐渐减小,至第12个月末两组之间上述指标无统计学差异;治疗后血黏度明显低于治疗前及对照组,至9个月时,与对照组之间无统计学差异。结论:前列地尔短程治疗糖尿病肾病,控制蛋白尿、降低血黏度、保护肾功能的作用,但对糖尿病肾病远期的肾保护有一定的局限性,在1年内这种保护作用逐渐消失。

AIM： To explore the clinical efficacy of alprostadil injection treatment on reducing urinary protein and lowering blood viscosity of type 2 diabetic patients with diabetic nephropathy and the treatment efficacy changes over time. METHODS： 48 patients with type 2 diabetic were divided into two groups randomly. Both groups were given integrated treatment on chronic renal insufficiency, diabetic, high blood pressure, high blood sugar. The trial group was treated with alprostadil 10μg/d for three weeks. The control group was given astragalus 30 mL/d intravenous infusion. The changes of urine albumin, blood viscosity and other clinical indicators were observed before and after the treatment and at the end of the 1, 3, 6, 9, 12th month. RESULTS： After treatment the urinary protein, blood viscosity of two groups were significantly decreased compared with those before treatment （P〈0.05）; The urinary protein of the experimental group was significantly lower than that of control group （P 〈0.05）, but as time past that of, this gap decreased gradually. To the end of the 12 month there was no significant difference between them, and there was no significant difference at the end of the 9 month on the blood viscosity between the two groups. CONCLUSION. Patients with diabetic nephropathy who had received the treatment of alprostadil three weeks could decrease proteinuria excretion, lower blood viscosity but this protection for renal has some limitations in a long-term , the effect of treatment diminishes little by little in a year.