硫辛酸联合前列地尔降低早期糖尿病肾病患者尿微量蛋白及胱抑素C含量的效果

Effects of lipoic acid combined with alprostadil on the reduction of the levels of cystatin C and urine trace protein in patients with early diabetic nephropathy

目的通过检测尿微量蛋白及胱抑素C含量探讨硫辛酸联合前列地尔对早期糖尿病肾病患者的临床疗效。方法选取2015年6月至2016年3月在上海市第一康复医院代谢及肾病康复科接受治疗、符合本研究纳入和排除标准的早期糖尿病肾病患者90例,根据接受治疗情况将患者分为3组:对照组、硫辛酸组、硫辛酸联合前列地尔组,每组30例。对照组患者仅服用常规药物,未使用静脉药物;在服用常规药物的同时,硫辛酸组患者给予硫辛酸注射液静脉滴注2周(300 mg/d),硫辛酸联合前列地尔组患者联合使用2种药物2周(硫辛酸300 mg/d,前列地尔20 g/d)。检测并记录3组患者尿微量蛋白及胱抑素C含量。结果与治疗前相比,治疗2周后对照组患者尿微量蛋白及胱抑素C含量无明显改变,硫辛酸组和硫辛酸联合前列地尔组患者尿微量蛋白及胱抑素C含量降低,硫辛酸联合前列地尔组降幅大于硫辛酸组,差异有统计学意义(P<0.05)。结论α-硫辛酸治疗能降低早期糖尿病肾病患者尿微量蛋白及胱抑素C含量,联合使用前列地尔疗效更为显著。

Objective To explore the clinical efficacy of lipoic acid combined with alprostadil on patients with early diabetic nephropathy （EDN） through the detection of cystatin C （CysC） and urine trace protein levels. Methods Ninety EDN patients admit-ted into the Department of Nephrology of the First Rehabilitation Hospital of Shanghai for treatment from June 2015 to March 2016 and who were confirmed to the inclusion and exclusion standards were enrolled for the study. In accordance with different treatment meth-ods ,the patients were divided into the control group, the a-lipoic acid group and the a-lipoic acid combined with alprostadil group （or the combination group）. The patients in the control group just received routine therapy without any intravenous drugs, the patients in the a-lipoic acid group were given intravenous a-lipoic acid injection at a dosage of 300 mg/d for 2 weeks, in addition to conventional drugs, and the patients in the combination group were treated with a-lipoic acid and alprostadil at dosages of 300mg and 20 g daily. Then, the levels of urine trace protein and cystatin C were detected and recorded. Results As compared with those before treatment, the urine trace protein and CysC levels of the patients in the a-lipoic acid and the combination groups were significantly decreased after treatment for 2 weeks （ P 〈 0. 05 ） . The levels of urine trace protein and CysC in the a-lipoic acid and the combination groups were all decreased, with the aptitude of the combination group being greater than that of the a-lipoic acid group （P 〈 0. 05 ） . Conclusion a-li- poic acid could decrease the levels of urine trace protein and CysC in the patients with early diabetic nephropathy, and the combined use of alprostadil could achieve better therapeutic results.