前列地尔联合左卡尼丁及还原型谷胱甘肽治疗中晚期慢性肾脏病临床观察

Clinical observation of alprostadil combined with left carnitine and glutathione in the treatment of chronic kidney disease in middle-late stage

目的观察前列地尔联合左卡尼丁及还原型谷胱甘肽(GSH)治疗中晚期慢性肾脏病(CKD)的临床效果。方法将56例慢性CKD患者随机分为A组和B组各28例。A组予前列地尔治疗,B组在A组基础上予左卡尼丁及还原型GSH治疗。治疗前后观察2组血清肌酐、尿素氮(BUN)、尿白蛋白/肌酐比率(ACR)、胱抑素、超敏C反应蛋白(hsCRP)、总胆固醇(TG)、低密度脂蛋白(LDL)、甲状旁腺素(iPTH)、表皮生长因子(eGFR)水平。结果治疗后,2组胱抑素、iPTH、ACR水平均低于治疗前,且B组低于A组,差异均有统计学意义(P<0.05);治疗后B组血红蛋白、hsCRP水平低于治疗前,且B组hsCPR水平低于A组,差异均有统计学意义(P<0.05);2组治疗前后血肌酐、TG、BUN、LDL及eGFR水平差异无统计学意义(P>0.05)。结论前列地尔联合左卡尼丁及还原型GSH治疗中晚期慢性CKD可有效改善CKD进展危险因素,但其长期疗效有待观察。

Objective To observe the clinical efficacy of alprostadil combined with left carnitine and glutathione （GSH） in the treatment of chronic kidney disease （CKD） in middle-late stage. Methods 56 cases patients with CKD were randomly divided into A group and B group,each of 28 cases. A group were treated with alprostadil,and B group,on basis of A group,were treated with left carnitine and GSH. The serum creatinine,blood urea nitrogen （BUN） ,urinary albumin/creatinine ratio （ACR） ,cystatin,high-sensitivity Creactive protein （hsCRP） ,total cholesterol （TG） ,low density lipoprotein （LDL） , thyroid next gonadotropin （iPTH） ,epidermal growth factor （eGFR） levels of 2 groups was observed. Results After treatment,the cystatin,iPTH,ACR levels were lower than before treatment,and B group were lower than A group,the differences was statistically significant （P0.05） ; after treatment,the hemoglobin,hsCRP levels of B group were lower than before treatment,and hsCPR level of B group was lower than A group,the differences was statistically significant （P0.05） ; the level of serum creatinine,TG,LDL and eGFR of 2 groups before and after treatment had no significant difference （P0.05） . Conclusion Alprostadil combined with left carnitine and GSH in the treatment of CKD in middle-late stage can effectively improve the risk factors,but its long-term efficacy remains to be seen.