前列地尔序贯疗法联合复方丹参滴丸对老年临床糖尿病肾病的治疗效果分析

Clinical efficacy analysis of combine alprostadil sequential therapy with Danshen driping pillsin treatment of elderly patients with diabetic nephropathy

目的探讨前列地尔序贯疗法联合复方丹参滴丸对老年临床糖尿病肾病的治疗效果。方法将老年糖尿病肾病患者80例,随机分为对照组和观察组,每组40例。对照组给予常规治疗+复方丹参滴丸(治疗4周);观察组在对照组的基础上给予前列地尔序贯治疗(前列地尔注射液2周,贝前列素钠片2周)。对2组患者治疗前后总蛋白、血栓素B2、肾血流、24 h尿微量白蛋白(UMA)以及尿6-酮-前列素F1α(6-keto-PGF1α)进行观察。结果治疗后,两组总蛋白和UMA水平显著降低,观察组总蛋白和UMA水平显著低于对照组(P<0.05);两组肾脏动脉、段动脉及叶间动脉阻力指数(RI)显著降低,观察组RI显著低于对照组(P<0.05);两组6-keto-PGF1α显著升高,观察组6-keto-PGF1α水平显著高于对照组(P<0.05);两组血栓素B2显著降低,观察组血栓素B2显著低于对照组(P<0.05)。结论前列地尔序贯疗法联合复方丹参滴丸可有降低老年临床糖尿病肾病患者尿蛋白水平,改善患者血流动力学。

Objective To investigate clinical efficacy of combine alprostadil sequential therapy with Danshen driping piUs in treatment of elderly patients with diabetic nephropathy. Methods 80 cases of eider patients with diabetic nephropathywere randomly divided into control group and observation group, 40 cases in each group. Patients in control group were given conventional treatment ＋Danshen driping pills for 4 weeks, and patients in observation group were given alprostadil sequential therapy（alprostadil injection for 2 weeks＋beraprost sodium tablets for 2 weeks） based on conventional treatment. The total protein, thromboxane B2,24 h urinary albumin （UMA） and urinary 6-keto-prostaglandin F1α levels and renal blood flow of two groups were observed. Results After treatment, UMA and total protein levels of two groups were significantly reduced, and UMA and total protein levels of observation group were significantly lower than those of control group （P〈0.05）; kidney artery, segmental arteries and leaves artery resistance index （RI） of two groups were significantly decreased, and RI of observation group was significantly lower than that of control group （P〈0.05）; 6-keto- PGF1α levels of two groups were significantly improved, and 6-keto-PGF1α of observation group was significantly higher than that of control group （P〈0.05）; thromboxane B2 levels of two groups were significantly increased,and thromboxane B2 level of observation group was significantly lower than that of control group （P〈0.05）. Conclusion Combine alprostadil sequential therapy with Danshen driping pills can effectively reduce the urinary protein level and improve hemodynamic of elderly diabetic nephropathy.