前列地尔注射液联合雷公藤多苷片对糖尿病肾病患者细胞因子浓度的影响

Effect of tripterygium glycosides combined with alprostadil on cytokine concentration in patients with diabetic nephropathy

目的观察雷公藤多苷片联合前列地尔注射液对糖尿病肾病患者血清白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)和肿瘤坏死因子-α(TNF-α)的影响。方法将90例糖尿病肾病患者随机分为A,B,C组,各30例。A组根据患者病史给予常规治疗;B组在A组的基础上静脉滴注前列地尔注射液10μg·d^(-1);C组在B组的基础上口服雷公藤多苷片60 mg·d^(-1),3组均连续治疗3个月。治疗后,观察3组患者的临床疗效及血清IL-6、hs-CRP、Hcy和TNF-α水平。结果治疗后,A,B,C组总有效率分别为63.33%(19/30例),80.00%(24/30例),90.00%(27/30例),B、C组与A组比较,差异有统计学意义(P<0.05)。治疗后,A,B,C组IL-6分别为(18.81±4.60),(15.53±3.40),(10.61±5.65)mg·L^(-1);hs-CRP分别为(9.49±3.52),(7.04±2.90)mg·L^(-1),(6.95±2.17)mg·L^(-1);Hcy分别为(24.83±4.83),(22.38±5.88),(14.15±7.79)mmol·L^(-1);TNF-α分别为(14.05±4.65),(13.17±2.21),(7.02±6.09)ng·L^(-1),3组IL-6、hs-CRP、Hcy和TNF-α与治疗前相比,差异均有统计学意义(P<0.05);且B、C组与A组比较,差异均有统计学意义(P<0.05)。3组治疗过程中均未出现恶心、呕吐、过敏、乏力等药物不良反应。结论雷公藤多苷联合前列地尔用于治疗糖尿病肾病患者,临床疗效显著,可明显降低IL-6、hs-CRP、Hcy和TNF-α水平。

Objective To observe the clinical effect of tripterygium glycosides combined with alprostadil in patients with diabetic nephropathy, and its effect on serum interleukin -6 （IL- 6 ）, hypersensitive C - reactive protein （ hs - CRP ）, homocysteine （ Hcy ） and tumor necrosis factor - α （TNF - α ）. Methods Ninety cases of diabetic nephropathy were randomly divided into A, B, C group, 30 cases in each group. Group A was given conventional treatment based on patients＇ history. Group B was given alprostadil injection 10 ·g · d-1 on the basis of group A. Group C was orally given tripterygium glycosides 60 mg · d-1 on the basis of group B. All patients were treated for 3 months. The clinical efficacy and levels of IL - 6, hs - CRP, Hey and TNF-a were observed in three groups. Results After treatment, the total effective rate in group A, B, C were 63. 33% （ 19/30 cases）, 80. 00% （24/30 cases） ,90. 00% （27/30 cases）, total efficacy in group B and C hadsignificant difference with group A （ P 〈 0. 05 ）. After treatment, the levels of IL - 6 in group A, B, C were （18.81 ±4. 60）,（15.53 ±3.40）, （10.61±5.65）mg · L-1. The levels of hs- CRP in group A, B, C were （9. 49 ±3.52） , （7.04 ±2. 90）, （6.95 ±2. 17）mg · L-1. The levels of Hcy in group A, B, C were（24. 83 ±4. 83）, （22. 38±5.88）,（14.15±7.79）mmol · L-1. The levels of TNF-α in group A, B, C were（14.05 ±4.65）, （ 13.17 ±2. 21 ）, （7.02 ± 6. 09 ） ng· L-1. The levels of IL - 6, hs - CRP, Hcy and TNF -α in three group had significant difference with before treatment, and group B and C had significant difference with group A （ P 〈 0. 05 ）. There was no nausea, vomiting, allergies, fatigue and other adverse drug reaction observed in three groups. Conclusion The clinical effect of tripterygium glycosides combined with alprostadil in patients with diabetic nephropathy was obvious, and can reduced the levels of IL - 6, hs - CRP, Hcy and TNF - or.