前列地尔治疗高龄糖尿病并慢性肾脏病患者的临床效果和安全性探讨

Clinical Efficacy and Safety of Alprostadil in the Treatment of Elderly Patients with Chronic Kidney Disease and Diabetes

目的探究前列地尔治疗高龄糖尿病并慢性肾脏病患者的临床效果与安全性。方法选取该院2013年5月—2014年10月收治的高龄糖尿病合并慢性肾脏病患者60例作为该次的研究对象,按照随机分组法分为Ⅰ组和Ⅱ组,每组患者各30例。Ⅰ组患者进行基础治疗;Ⅱ组患者先采取基础治疗14 d后再给予10μg的前列地尔注射液静推,观察用药期间药物的安全性,观察指标包括:肾功能与尿蛋白、凝血功能、血脂、血糖、肝功能、血压等指标。结果两组患者使用前列地尔治疗后,其中UAER、ACR、LDL-c、CHOL等血脂指标与治疗前相比均明显下降,两组比较差异有统计学意义(P<0.05);凝血功能指标(PLT、PT、FIB、APTT)、FBG、D-DI、Hb Alc等指标水平与治疗前相比无明显差异,差异无统计学意义(P>0.05);治疗后的临床效果分析:与基础治疗相比,采用基础治疗联合前列地尔注射液治疗的临床效果更佳,两组比较差异有统计学意义(P<0.05)。结论对高龄糖尿病并慢性肾脏病患者采用前列地尔治疗的临床效果显著,药物安全性高,无明显不良反应,值得进一步推广并应用。

Objective To investigate the clinical effect and safety of alprostadil in the treatment of elderly patients with diabetes mellitus and chronic kidney disease.Methods 60 patients with diabetes and chronic kidney disease treated in our hospital from May 2013 to October 2014 were selected as the subjects and randomly divided into group Ⅰ and group Ⅱ,30 cases in each group.Patients in group I were treated by basic treatment,and those in group Ⅱ were given the basic treatment for 14 days and then given intravenous injection of 10μg alprostadil.And the safety during the treatment was observed.The observation indexes included renal function and proteinuria,coagulation function,blood lipids,blood glucose,liver function and blood pressure and so forth.Results After the treatment of alprostadil,the UAER,ACR,LDL-C,CHOL and other blood lipid indicators significantly decreased compared with those before treatment,and the differences between the two groups had statistically significance（P〈0.05）.The differences in the levels of coagulation parameters（PLT,PT,FIB,APTT）,FBG,D-DI and Hb Alc before and after treatment were not statistically significant（P〉0.05）.The analysis showed that basic treatment combined with intravenous injection of alprostadil has better effect than basic treatment,the difference in clinical effect between the two groups was statistically significant（P〈0.05）.Conclusion For elderly patients with diabetes and chronic kidney disease,alprostadil has significant clinical effect and high safety without obvious adverse reactions,so it is worth further promotion and application.