前列腺素E1在高血压肾脏损害中的早期临床应用

Clinical application of prostaglandin Ej in the treatment of hypertensive renal damage of early stage

目的观察静脉注射前列腺素E1对高血压合并微量白蛋白尿患者肾小球及。肾小管功能的改善作用。方法选取60例高血压合并微量白蛋白尿及夜尿增多患者，进入研究前已接受氯沙坦钾治疗12周以上，按随机数字表法分为治疗组和对照组，每组30例。治疗组和对照组原有降压药物均继续服用，治疗组给予前列腺素E1治疗3个疗程，同时常规使用氯沙坦钾及其他降压药物，采用自身治疗前后对比及与对照组对比，观察患者前列腺素E1治疗前后尿微量白蛋白（mALB）、尿渗透浓度、尿β2微球蛋白（B2-MG）及尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）的变化情况。结果两组治疗后血压均下降，但与治疗前比较差异无统计学意义（P〉0．05）。治疗组治疗后12周尿mALB、尿p2_MG及尿NAG均低于对照组[（88．6±14．2）μg,／min比（123．9±14．8）μg／min、（0．84±0．41）mg／L比（1．61±0．49）mg／L、（30．2±10．5）u，L比（75．7±12．8）U／L]，尿渗透浓度高于对照组[（591±71）mmol／L比（454±67）mmol／L]，差异均有统计学意义（P〈0．01）。结论前列腺素E。可减轻早期高血压肾脏损害患者肾脏缺血状态，改善肾脏功能。

Objective To observe the effect of prostaglandin El intravenously in the improvement of the function of renal glomeruli and renal tubules in hypertensive patients complicated with microalbuminuria. Methods Totally 60 hypertensive patients complicated with microalbuminuria and nocturia who had received losartan for above 12 weeks, according to random number table method were divided into treatment group and control group, with 30 cases in each group. Original antihypertensive drugs were used continuously in treatment group and control group, and patients in treatment group received prostaglandin E1 intravenously for 3 courses of treatment, with losartan and other antihypertensive drugs routinely. Using self-contrast before and after treatment and contrast with control group, the change of urinary level of microalbumin （mALB）, osmotic pressure,β 2-microglodulin （ β2-MG） and N-acetyl- 13 -D-glucosaminidase （NAG） were compared. Results The blood pressure after treatment in both groups were decreased, but there was no statistically significant difference compared with that before treatment （P〉 0.05）. After treatment of 12 weeks, urinary levels of mALB, β2-MG and NAG in treatment group were lower than those in control group [ （88.6 ± 14.2） μ g/min vs.（ 123.9 ± 14.8） μg/min, （0.84 ±0.41） mg/L vs.（ 1.61 ±0.49） mg/L, （30.2 ± 10.5） U/L vs. （75.7 ± 12.8） U/L] ,and osmotic pressure was higher than that in control group [ （591± 71 ） mmol/L vs. （454 ± 67 ） mmol/L], the difference had statistical significance （P 〈 0.01 ）. Conclusion Prostaglandin El can reduce the renal ischemic state in early stage of hypertensive renal damage and can improve renal function.