前列地尔联合格列喹酮治疗老年糖尿病肾病的疗效观察

Clinical observation of alprostadil combined with gliquidone in treatment of elderly diabetic nephropathy

目的探讨前列地尔联合格列喹酮治疗老年糖尿病肾病的临床效果。方法选取2013年9月—2016年3月内蒙古医科大学附属医院接收治疗的糖尿病肾病患者80例,随机分为对照组与治疗组,每组各40例。对照组患者在常规治疗的基础上餐前半小时口服格列喹酮片30~60 mg/d,1次/d。治疗组在对照组的基础上静脉滴注前列地尔注射液,10μg加入到生理盐水100 m L中,1次/d。两组患者均连续治疗4周。然后观察两组临床疗效,同时比较两组患者空腹血糖（FBG）、餐后2 h血糖、尿蛋白排泄率（UPER）、血肌酐（Scr）、24 h尿蛋白（24 h Upro）和肾小球滤过率（e GCR）水平变化。结果治疗后,对照组和治疗组的总有效率分别为82.5%和97.5%,两组总有效率比较差异有统计学意义（P〈0.05）。治疗后,两组患者FBG和餐后2 h的血糖水平均显著降低（P〈0.05）;且治疗后治疗组患者的血糖水平比对照组降低的更明显（P〈0.05）。治疗后,两组患者24 h Upro、Scr和UPER与治疗前相比明显降低,同组治疗前后比较差异有统计学意义（P〈0.05）;且治疗后治疗组患者24 h Upro、Scr和UPER水平与对照组相比降低更明显,两组比较差异具有统计学意义（P〈0.05）;而治疗前后两组患者e GFR水平比较差异没有统计学意义。结论前列地尔联合格列喹酮治疗老年糖尿病肾病效果显著,能够有效改善患者的血糖及肾功能,具有一定的临床推广应用价值。

Objective To observe the curative effect of alprostadil combined with gliquidone in treatment of elderly diabetic nephropathy. Methods Patients （80 cases） with diabetic nephropathy in the Affiliated Hospital of Inner Mongolia Medical University from September 2013 to March 2016 were randomly divided into the control and treatment groups, and each group had 40 cases. The patients in the control group were po administered with Gliquidone Tablets half an hour before meals based on the conventional therapy, 30 - 60 mg/d, once daily. The patients in the treatment group were iv administered with Alprostadil Injection on the basis of the control group, 10 μg added into normal saline 100 mL, once daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the change of FBG, 2 h postprandial glucose, UPER, Scr, 24 h Upro, and eGCR levels in two groups was compared. Results After treatment, the clinical efficacy in the control and treatment group was 82.5% and 97.5%, respectively, and there were differences between two groups （P 〈 0.05）. Alter treatment, FBG and 2 h postprandial glucose levels in two groups were significantly decreased （P 〈 0.05）. And FBG and 2 h postprandial glucose levels in the treatment group decreased more than those in the control group, with significant difference between two groups （P 〈 0.05）. After treatment, 24 h Upro, Scr, and UPER levels in two groups were significantly decreased, and the difference was statistically significant in the same group （P 〈 0.05）. And 24 h Upro, Scr, and UPER levels in the treatment group decreased more than those in the control group, with significant difference between two groups （P 〈 0.05）. However, there was no significant difference in eGFR between two groups before and after treatment. Conclusion Alprostadil combined with gliquidone has a significant clinical effect in treatment of elderly diabetic nephropathy, can effectively improve the blood glucose and renal function, which has a certain clinical application value.