前列地尔联合血塞通注射液对早期糖尿病肾病尿蛋白的影响

Effect of alprostadil combined with Sanqi Panax Notoginseng Injection on proteinuria in early diabetic nephropathy

目的探讨短期静脉应用前列地尔联合血塞通注射液对早期糖尿病肾病患者肾功能及尿蛋白的影响。方法选取血糖、血压稳定的早期糖尿病肾病患者85例,随机分为对照组20例、前列地尔(凯时)组20例、血塞通组22例、前列地尔联合血塞通(联合)组23例。凯时组予以凯时10μg,每日1次,连续14天;血塞通组静脉滴注血塞通注射液4ml(加入木糖醇注射液250ml),每日1次,连续14天;联合组静脉给予凯时10μg及血塞通注射液4ml,每日1次,连续14天;对照组只给予对症治疗,包括控制血糖、血压、血脂等基本治疗方法各组相同。结果凯时组、血塞通组及联合组治疗后尿总蛋白、微量白蛋白和血、尿β2微球蛋白均明显下降(P<0.05)。与对照组比较,凯时组、血塞通注射液组及联合组患者24小时尿总蛋白、微量白蛋白和尿β2微球蛋白明显降低(P<0.01),凯时组、血塞通组血β2微球蛋白明显降低(P<0.05),联合组血β2微球蛋白降低更明显(P<0.01)。联合组尿总蛋白、微量白蛋白、血、尿β2微球蛋白较凯时组和血塞通注射液组均明显降低(P<0.05)。结论前列地尔与血塞通注射液短期静脉应用均能明显降低早期糖尿病肾病患者尿蛋白,但二者联合应用疗效更显著,但对尿素氮及肌酐无明显影响。

Objective To observe the effect of alprostadil combined with Sanqi Panax Notoginseng Injection on renal function and proteinuria in early diabetic nephropathy.Methods A total of 85 patients with early diabetic nephropathy were divided randomly into four groups,including 20 patients in control group,20 patients treated with alprostadil 10μg daily for 14 days,22patients treated with Sanqi Panax Notoginseng Injection 4ml daily for 14 days and 23 patients treated with alprostadil 10μg combined with Sanqi Panax Notoginseng Injection 4ml daily for 14 days.The control group only got management of blood glucose,blood pressure and blood lipid.Results In the treating group（alprostadil group,Sanqi Panax Notoginseng Injection group and the combination treatment group）,the levels of 24-h urinary proteinuria,microalbuminuria,blood and urineβ2-MG significantly reduced after treatment（P〈0.05）.In the treating group,the levels of 24-h urinary proteinuria,microalbuminuria and urineβ2-MG significantly reduced as compared with the control group（P〈0.01）;Bloodβ2-MG also significantly reduced in the alprostadil group and Sanqi Panax Notoginseng Injection group than in the control group（P〈0.05）,and more reduced in the combination treatment group（P〈0.01）;In the combination treatment group,the levels of 24-h urinary proteinuria,microalbuminuria,blood and urineβ2-MG were significantly decreased as compared with alprostadil and Sanqi Panax Notoginseng Injection group（P〈0.05）.Conclusion Both alprostadil and Sanqi Panax Notoginseng Injection may decrease proteinuria in patients with early diabetic nephropathy,while combination treatment may be more prominent but without significant effect on the urea nitrogen and creatinine.