贝前列素对糖尿病肾病患者血清胱抑素C及炎性因子水平的影响

The impact of beraprost on the levels of Cys C and micro inflammatory cytokine in diabetic nephropathy patients

目的观察贝前列素对糖尿病肾病（DN）患者血清胱抑素C（Cys-C）及炎性因子水平的影响。方法选择2014年8月—2015年8月重庆永川区中医院DN患者84例,根据随机数字表将患者分为观察组及对照组各42例,2组患者均进行糖尿病饮食管理,积极治疗糖尿病,控制患者空腹血糖水平及餐后血糖水平,同时给予患者降糖、降压治疗。观察组在此基础上给予贝前列素治疗,持续服药4周,对比分析2组患者治疗效果及治疗前后血清Cys-C及炎性因子水平的变化。结果观察组总有效率为95.24%,明显高于对照组的76.19%（χ^2=6.222,P〈0.05）。治疗后,观察组尿素氮（BUN）、血肌酐（SCr）、尿红细胞（RBC）及24 h尿蛋白排泄率（24 h UAER）分别为（4.32±1.23）mmol/L、（86.93±14.67）μmol/L、（23.62±7.98）个/μl、（36.28±6.25）μg/min低于对照组（7.98±1.54）mmol/L、（102.62±21.25）μmol/L、（35.87±9.65）个/μl、（98.36±8.36）μg/min（P〈0.01）;观察组治疗后CysC及C反应蛋白（CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平分别为（1.02±0.15）μmol/L、（0.75±0.18）mg/ml、（12.25±4.02）ng/ml、（4.25±0.85）ng/ml,对照组分别为（1.72±0.13）μmol/L、（3.98±0.85）mg/ml、（28.25±3.89）ng/ml、（6.85±0.96）ng/ml,2组治疗后上述指标均较治疗前显著下降,且观察组较对照组下降更明显（P均〈0.01）。结论贝前列素可有效减轻DN患者炎性反应及降低血清Cys-C水平,改善患者肾功能功能,提高患者治疗效果。

Objective To observe the effect of beraprost on diabetic nephropathy（DN）patients＇ serum cystatin C（Cys C） and inflammatory factor levels.Methods Eighty-four cases of patients with DN from August 2014 to August 2015 at Chongqing Yongchuan District Traditional Chinese Medicine Hospital were enrolled,according to the random number table,these patients were divided into observation group and control group,42 cases in each group,2 groups of patients were with diet management of diabetes mellitus,aggressive treatment of diabetes,control of fasting blood glucose level and meal after the blood glucose level,patients also received a hypoglycemic and antihypertensive therapy.Observation group on the basis of these therapy,also given beraprost treatment,the treatment lasted for 4 weeks,comparative analysis of two groups treatment effect before and after treatment,serum Cys C and inflammatory factor level changes were compared.Results Observation group＇s total effective rate was 95.24%,which was higher than the control group＇s 76.19%（χ^2=6.222,P〈0.05）.After treatment,the observation group＇s urea nitrogen（BUN）,serum creatinine（SCr）,urinary red blood cell（RBC） and 24 h urinary albumin excretion rate（24 h UAER）were（4.32±1.23）mmol/L,（86.93±14.67）μmol/L,（23.62±7.98）/μl,（36.28±6.25）μg/min,the control group were（7.98±1.54）mmol/L,（102.62±21.25）μmol/L,（35.87±9.65）/μl,（98.36±8.36）μg/min（P〈0.05）;after treatment,observation group＇s Cys C and C-reactive protein（CRP）,interleukin 6（IL-6）,tumor necrosis factor α（TNF-α） levels were（1.02±0.15）μmol/L,（0.75±0.18）mg/ml,（12.25±4.02）ng/ml,（4.25±0.85）ng/ml,the control group were（1.72±0.13）μmol/L,（3.98±0.85）mg/ml,（28.25±3.89）ng/ml,（6.85±0.96）ng/ml,both groups were significantly decreased,and observation group were lower than control group（P〈0.01）.Conclusion Beraprost can effectively reduce the DN patients＇ inflammatory reaction and decrease serum Cys C level,improve the function of kidney function,improve the effect of treatment.