己酮可可碱对老年糖尿病肾病早期治疗作用的研究

The hemorrheological effect in the elderly patients with incipient diabetic nephropathy

目的 :探讨血液流变性改善剂己酮可可碱对老年糖尿病肾病早期的治疗作用。方法 :将 10 6例 型糖尿病伴有微量白蛋白尿患者随机分为 2组治疗 ,己酮可可碱组 6 6例 ,卡托普利 (开博通 )组 40例 ,治疗期为 6个月。结果 :2组治疗后尿总蛋白 (U TP)及尿白蛋白排泄率 (U AER)均明显降低〔己酮可可碱组 U TP从 (0 .2 1± 0 .0 6 ) g/ 2 4h 降至 (0 .12± 0 .0 4) g/ 2 4h,P<0 .0 1;U AER从 (132 .6 5± 5 3.5 8) μg/ min降至 (5 5 .82±2 7.17) μg/ m in,P<0 .0 1。卡托普利组 UTP从 (0 .19± 0 .0 6 ) g/ 2 4h降至 (0 .13± 0 .0 5 ) g/ 2 4h,P<0 .0 1;UAER从 (115 .2 6± 5 3.35 )μg/ min降至 (75 .6 2± 43.34)μg/ min,P<0 .0 1〕。肌酐清除率 (CCr)有所改善〔己酮可可碱组从 (1.37± 0 .16 ) m l· s- 1 · 1.73 m- 2 增到 (1.48± 0 .2 2 ) ml· s- 1 · 1.73 m- 2 ,P<0 .0 5 ;卡托普利组从 (1.33±0 .2 7) ml· s- 1 · 1.73 m- 2 )增到 (1.43± 0 .34) ml· s- 1 · 1.73 m- 2 ,P<0 .0 5〕,治疗后 2组间比较无明显差异(P>0 .0 5 )。2组对血压和血脂都有一定良好的影响。结论 :己酮可可碱有减少尿蛋白、改善肾功能的作用 ,对老年 型糖尿病早期肾病有确切的治疗作用。

Objective:To observe the effect of using pentoxifylline on elderly patients with diabetic nephropathy.Methods:One hundred and six patients with tape Ⅱ diabetic and microalbuminura were randomly divided into two groups:66 patients for using pentoxifylline 800 mg daily;40 patients for using captopril 37.5 mg daily,6 months was one course of treatment.Results:Urinary total protern (UTP) ond urinary albumin excretion rates(UAER) were significantly decreased in both groups ofter treatmeat.In pentoxifylline group,the UTP was decreased from(0.21±0.06)g/24 h to (0.12±0.04)g/24 h,P<0.01;the UAER was decreased from(132.65±53.58)μg/min to(55.82±27.17)μg/min,P<0.01.In Captopril group,the UTP was decreased from(0.19±0.06)g/24 h to (0.13±0.05)g/24 h,P<0.01;the UAER was decreased from(115.26± 53.35)μg/min to(75.62±43.34)μg/min,P<0.01.Creatinine clearance rates(CCr) were improved from (1.37±0.16)ml·s -1·1.73 m -2 to (1.48±0.22)ml·s -1·1.73 m -2 in pentoxifylline group,P<0.05, and from (1.33±0.27)ml·s -1·1.73 m -2 to (1.43±0.34)ml·s -1·1.73 m -2 in captopril group,P<0.05.Two groups were compared no difference,P>0.05.Conclusions:Pentoxifylline have function on decreasing the urinary albumin and improving the renal function; also have the exact benefits to cure elderly type Ⅱ incipient diabetic nephropathy.