前列地尔、阿司匹林与瑞格列奈联合治疗老年糖尿病肾病病人的临床效果

Effect of alprostadil,aspirin combined with repaglinide on oxidative stress,blood rheology and inflammatory factors in elderly patients with diabetic nephropathy

目的探究前列地尔、阿司匹林与瑞格列奈联合治疗对老年糖尿病肾病病人氧化应激反应、血液流变学及炎症因子的影响。方法选取我院收治的80例老年糖尿病肾病病人,按随机数字表法分为研究组和对照组,每组各40例,对照组病人给予常规治疗,研究组病人在此基础上给予前列地尔、阿司匹林与瑞格列奈的联合治疗,检测2组病人治疗前后氧化应激反应、血液流变学及炎症因子水平的变化情况。结果治疗前2组病人氧化应激反应、血液流变学及炎症因子水平比较差异无统计学意义(P>0.05)。与治疗前相比,经过相关治疗后2组病人丙二醛(MDA)、血液流变学指标全血黏度高切(BVH)、全血黏度中切(BVM)、全血黏度低切(BVL)、纤维蛋白原(FIB)、红细胞压积(PCV)和炎症因子白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C-反应蛋白(hs-CRP)水平显著降低,IL-2和氧化应激指标谷胱甘肽过氧化物酶(GSH-Px)、过氧化氢酶(CAT)、超氧化物歧化酶(SOD)水平显著升高,差异均有统计学意义(P<0.05)。研究组上述指标改善均较对照组更显著,差异有统计学意义(P<0.05)。结论前列地尔、阿司匹林与瑞格列奈的联合治疗能够抑制老年糖尿病肾病病人的氧化应激反应,提高病人的血液流动情况,改善炎症反应,对老年糖尿病肾病病人的临床治疗具有重要的意义。

Objective To observe the effect of alprostadil,aspirin combined with repaglinide on oxidative stress,blood rheology and inflammatory factors in elderly patients with diabetic nephropathy.Methods Eighty elderly patients with diabetic nephropathy were selected and randomly divided into research group（ 40 cases） and control group（ 40 cases）. The patients in control group were treated with basic treatment and the patients in research group were treated with alprostadil,aspirin combined with repaglinide on the basis of control group. Oxidative stress,blood rheology and inflammatory factors were detected before and after treatment and compared between two groups. Results Before treatment,oxidative stress,blood rheology and inflammatory factors of two groups showed no significant difference.After treatment,the levels of malonaldehyde（ MDA）,blood viscosity of high shear rate（ BVH）,blood viscosity of moderate shear rate（ BVM）,blood viscosity of low shear rate（ BVL）,fibrinogen（ FIB）,packed cell volume（ PCV）,interleukin-6（ IL-6）,tumor necrosis factor-α（ TNF-α）,and high-sensitivity C-reactive protein（ hs-CRP） of two groups were decreased significantly（ P 0. 05）. The levels of IL-2 and oxidative stress index such as glutathione peroxidase（ GSH-Px）,catalase（ CAT）,and superoxide dismutase（ SOD） of two groups were significantly higher than those before treatment（ P 0. 05）. After treatment,all above paramteters in research group were more significiantly improved than those of control group（ P〈0. 05）. Conclusions Alprostadil,aspirin combined with repaglinide can inhibit oxidative stress,improve blood oxygen level,and relieve inflammatory reaction. It has important clinical value for diabetic nephropathy.