前列地尔对慢性肾功能衰竭患者血清炎症因子水平及营养生化指标的影响

Effect of alprostadil on serum levels of inflammatory cytokines and nutritional biochemical indexes in patients with chronic renal failure

目的探讨前列地尔对慢性肾功能衰竭患者血清炎症因子水平及营养生化指标的影响。方法根据随机数字表法将郑州大学第五附属医院于2012年4月~2014年4月纳入的129例慢性肾功能衰竭患者随机分为观察组（n=67）和对照组（n=62）。对照组采用常规对症治疗,观察组在对照组基础上结合前列地尔治疗。2组疗程均为4周。对比分析2组治疗前后Scr、BUN、IL-6、CRP、TNF-α、Ca^2＋、ALB、P^3＋、Hb、RBC、血液流变学指标变化。结果 2组Scr、BUN水平治疗后较治疗前显著降低（P〈0.05）,观察组Scr、BUN水平治疗后显著低于对照组（P〈0.05）。2组血清IL-6、TNF-α、CRP治疗后较治疗前显著下降（P〈0.05）,观察组血清IL-6、TNF-α、CRP治疗后显著低于对照组（P〈0.05）。观察组Ca^2＋、ALB治疗后显著高于对照组,P^3＋显著低于对照组（P〈0.05）,而Hb、RBC治疗后比较不具有统计学差异。观察组血液流变学指标水平均较治疗前显著降低（P〈0.05）。结论前列地尔对慢性肾功能衰竭患者机制可能与减低血清炎症因子水平、改善血液流变学等相关,有效地延缓慢性肾功能衰竭的进展。

Objective To investigate effect of alprostadil on serum levels of inflammatory cytokines and nutritional biochemical indexes in patients with chronic renal failure.Methods According to the random number table, 129 patients with chronic renal failure patients were included in this group and randomly divided into observation groups （n=67） and control group （n=62）.Control group were given conventional symptomatic treatment, and the observation group were given alprostadil treatment on the basis of control group with a course of four weeks of both groups.The Scr, BUN, IL-6, TNF-α, CRP, Ca^2 ＋, ALB, P^3 ＋, Hb, RBC, hemorheology changes were compared before and after treatment.Results The Scr, BUN levels after treatment was significantly lower than before treatment （P〈0.05）, and Scr, BUN levels in observation group after treatment was significantly lower than control group （P〈0.05）.Serum levels of IL-6, TNF-α, CRP after treatment significantly decreased than before treatment （P〈0.05）, serum IL-6, TNF-α, CRP after treatment was significantly lower than control group （ P〈0.05 ）.After treatment, Ca^2 ＋, ALB levels of observation group was significantly higher than control group and P^3 ＋was significantly lower than control group （P〈0.05）, while there were no significant differences of Hb, RBC.The hemorheology of observation group before treatment was significantly lower than control group （ P〈0.05 ） .Conclusion Alprostadil can significantly improve renal function, and the possible mechanism may be associated with reducing serum levels of inflammatory factors and improving blood rheology, which delay progression of chronic renal failure effectively.