缬沙坦联合前列地尔对早期糖尿病肾病的临床研究

Clinical study of valsartan combined with alprostadil in the treatment of patient with early diabetic nephropathy

目的观察缬沙坦联合前列地尔治疗早期糖尿病肾病的临床疗效及安全性。方法 98例早期糖尿病肾病患者分为A组33例,B组31例,C组34例。A组静脉滴注前列地尔100μg+0.9%Na Cl 250 m L,每日1次;B组口服缬沙坦80mg,每日1次;C组静脉滴注前列地尔100μg+0.9%Na Cl 250 m L,口服缬沙坦胶囊80 mg,每日1次,3组疗程均为1个月。比较3组的临床疗效及血清肌酸酐、尿素氮和尿白蛋白排泄率。结果治疗后A、B和C组临床总有效率分别为75.76%,70.96%和94.12%,C组临床有效率显著高于A和B组(P<0.05)。治疗后,3组患者血清尿素氮、血清肌酸酐及尿白蛋白排泄率均较治疗前显著降低(P<0.05),C组降低更显著(P<0.05)。A、B、C组不良反应发生率分别为9.09%,12.90%和11.76%,差异无统计学意义(P>0.05)。结论缬沙坦联合前列地尔可显著提高早期糖尿病肾病的临床疗效,降低血清尿素氮、血清肌酸酐及尿白蛋白排泄率水平。

Objective To evaluate the clinical efficacy and safety of alsartan combined with alprostadil in the treatment of early diabetic nephropathy. Methods Ninety-eight early diabetic nephropathy patients were divided into three groups,33 patients in group A,31 patients in group B,and 34 patients in group C. Patients in group A were given alprostadil 100 μg ＋ 0. 9% Na Cl 250 m L,qd. Patients in group B were given valsartan 80 mg,qd. And patients in group C were givenalprostadil100 μg ＋ 0. 9% Na Cl 250 m L ＋ valsartan 80 mg,qd. After 1 month treatment,the clinical efficacy and serum blood urea nitrogen（ BUN）,serum creatinine（ Scr） and urinary albumin excretion rate（ UAER） were observed in two groups. Results Total efficacy were75. 76%,70. 96%and 94. 12% for group A,B and C,without no significant statistical difference（ P〉0. 05）. The BUN,Scr and UAER were significant decreased after treatment for all three groups（ P〈0. 05）,group C much lower than other groups after treatment（ P〈0. 05）. The incidence rates of adverse drug reactions were 9. 09%,12. 90% and 11. 76% for the 3groups,with no statistical difference（ P〉0. 05）. Conclusion The clinical efficacy of valsartan combined with alprostadil was superior to the single drug in the treatment of early diabetic nephropathy which could decreased the BUN,Scr and UAER.