硝苯地平缓释片联合前列地尔对糖尿病肾病合并高血压患者肾功能的保护

Protective Effect of Nifedipine Extended-Release Tablets Combined with Alprostadil on Renal Function in Patients with Diabetic Kidney Disease Complicated with Hypertension

目的 探讨硝苯地平缓释片联合前列地尔对糖尿病肾病合并高血压患者肾功能的保护作用.方法 将2016年3月—2017年1月无锡市第二人民医院内分泌科收治的110例糖尿病肾病合并高血压患者随机分为观察组和对照组各55例.两组均予以饮食、运动干预,以及降糖、降脂等常规治疗.对照组在此基础上加用硝苯地平缓释片（30 mg/次,1次/d）,观察组在对照组基础上加用前列地尔（10μg/次,1次/d）.疗程均为3个月.治疗后对两组临床疗效进行判断,比较治疗前后患者收缩压（SBP）、舒张压（DBP）、尿白蛋白排泄率（UAER）、尿微量白蛋白/肌酐比值（mALB/Ucr）、血清肌酐（Scr）、尿素氮（BUN）、β2-微球蛋白（β2-MG）、胱抑素C（Cys-C）.结果 观察组临床疗效显著优于对照组（Z=2.193,P=0.029）,且两组不良反应总发生率差异无统计学意义（7.3％vs 5.5％,χ2=0.153,P=0.696）.治疗前,两组SBP、DBP、脉压差、UAER、mALB/Ucr、Scr、BUN、Cys-C和β2-MG比较差异均无统计学意义（P〉0.05）.与治疗前比较,两组治疗后的SBP、DBP、脉压差、UAER、mALB/Ucr、Scr、BUN、Cys-C和β2-MG均明显降低（P〈0.05）,而且观察组降低更加显著（P〈0.05）.结论 硝苯地平缓释片联合前列地尔对糖尿病肾病合并高血压患者的疗效确切,可有效控制血压,改善肾功能,且不增加不良反应.

Objective To investigate the protective effect of nifedipine extended-release tablets combined with alprostadil on renal function in patients with diabetic kidney disease complicated with hypertension. Methods A totalof 110 patients with diabetic kidney disease complicated with hypertension who were treated in endocrinology department of Wuxi No.2 People＇s Hospital from March 2016 to January 2017 were selected as research objects. All of the patients were randomly assigned into observation group （n=55） and control group （n=55）. All of the patients were treated with intervention of diet and exercise, and strict glycemic control. Patients in the control group were treated with nifedipine extended-release tablets （30 mg/time, 1 time/d） on the basis of conventional therapy, while patients in the observation group were treated with alprostadil （10μg/time, 1 time/d） on the basis of the control group. The course of treatment was 3 months. The following biochemical index was detected before and after treatment： systolic blood pressure （SBP）, diastolic blood pressure （DBP）, pulse pressure, urinary albumin excretion rate （UAER）, urinary albumin/creatinine ratio （mALB/Ucr）, serum creatinine （Scr）, urea nitrogen （BUN）, β2-microglobulin （β2-MG）, Cystatin C （Cys-C）. Results The clinical efficacy of the observation group was significantly better than the control group （Z=2.193, P=0.029）, and the total incidence of adverse reactions of the two groups had no statistical difference （7.3% vs 5.5%,χ2=0.153, P=0.696）. Compared with before treatment, the SBP, DBP, pulse pressure, UAER, mALB/Ucr, Scr, BUN, β2-MG and Cys-C were significantly decreased in the two groups （P〈0.05）, and the observation group was lower than the control group （P〈0.05）. Conclusion Nifedipine extended-release tablets combined with alprostadil is effective in the treatment of diabetic kidney disease complicated with hypertension, can effectively control blood pressure, improve renal function, and does not increase adverse reactions.