复方α-酮酸联合前列地尔与贝前列素钠序贯治疗老年3期慢性肾脏病的疗效分析

Clinical efficacy of compound a-ketoacid combined with alprostadil and beraprost sodium sequential for stage 3 chronic kidney disease on senile patients

目的观察复方α-酮酸联合前列地尔与贝前列素钠序贯治疗老年3期慢性肾脏病（CKD）的疗效。方法将65例老年3期CKD患者随机分为对照组20例、复方α-酮酸治疗组（酮酸组）22例、复方仪．酮酸联合前列地尔与贝前列素钠序贯治疗组（联合治疗组）23例，分别予以相应治疗14周。检测并比较各组患者治疗前后胱抑素C（CysC）、血尿素氮（BUN）、血肌酐（Scr）、纤维蛋白原、D-二聚体、凝血酶原时间（PT）、PLT计数等指标的变化。结果酮酸组及联合治疗组患者治疗后Scr、BUN及CysC水平较治疗前下降，估算的肾小球滤过率（eGFR）较治疗前升高，与对照组比较差异有统计学意义（P〈0．05）；与酮酸组比较，联合治疗组Scr、BUN、CysC及eGFR的改善更加明显（P〈0．05）；联合治疗组纤维蛋白原、D-二聚体均较治疗前下降（P〈0．05），且与对照组、酮酸组比较，差异有统计学意义（P〈0．05），各治疗组PT、PLT计数较治疗前无明显改变（P〉0．05）。结论复方α-酮酸联合前列地尔与贝前列素钠序贯治疗可延缓老年3期CKD的进展。

Objective To observe the efficacy of compound α-ketoacid combined with alprostadil and beraprost sodium sequential for chronic kidney disease （CKD） on senile patients. Methods A total of 65 senile patients with stage 3 CKD were randomly divided into the control group （n = 20）, compound α-ketoacid tablets treatment group （ ketoacoid n = 22 ）, compound α-ketoacid combined with alprostadil injection and beraprost sodium sequential treatment group （ combined treatment group, n = 23 ）. Every group received corresponding treatment respectively for 14 weeks. Cystatin C （Cys C ）, urea nitrogen （ BUN）, serum creatinine （ Scr ）, fibrinogen. D - dimer, plasma prothrombin time （PT） and platelet （PLT） count were tested and compared before and after the treatment. Results After 14 weeks of treatment, compared with before treatment, Scr, BUN, Cys C decreased and eGFR increased significantly in patients of α-ketoacid group and the combined treatment group, and the differences of dove indexes between them and the control group were significant（ P 〈 0.05 ）. But the combined treatment group changed more signifi- cantly（P 〈 0.05 ）. The patients in combined treatment group showed significantly decreased changes of Cys C, BUN, Scr and eGFR （ P 〈 0.05 ） than those in ketoacid group. Fibrinogen and D-dimer after treatment decreased significantly than those before treatment in the combined treatment group（P 〈 0.05 ）. Compared with other two groups, the difference were statistically significant （ P 〈 0.05 ）. The PT and PLT count showed no significant changes after treatment in the three groups （P 〉 0.05）. Conclusion Compound α-ketoacid combined with alprostadil and beraprost sodium sequential can delay the progression of CKD on senile patients.