前列地尔干乳剂联合贝那普利对糖尿病肾病患者尿蛋白水平的影响及其不良反应

Effect of alprostadil dry emulsion combined with benazepril on the protein level of patients with diabetic nephropathy and its adverse reactions

目的探讨前列地尔干乳剂联合贝那普利对糖尿病肾病患者尿蛋白水平的影响及其不良反应。方法将66例糖尿病肾病患者随机分为联合组和对照组(每组33例)。对照组常规行降糖、降压、抗凝和贝那普利口服治疗,联合组在对照组的治疗基础上采用前列地尔前列地尔干乳剂治疗。比较两组疗效,治疗前、治疗2周及4周的24 h尿蛋白水平、24 h尿微白蛋白排泄率(UMER)、血肌酐水平、临床症状积分及治疗期间不良反应发生率,分析24 h尿蛋白水平与UMER、血肌酐水平及临床症状积分的关系。结果与对照组相比,联合组治疗显效比例、总治疗有效率提高,治疗2周及4周的24 h尿蛋白水平、UMER、血肌酐水平及临床症状积分则均降低(P<0.05)。与治疗前相比,联合组治疗2周及4周的24 h尿蛋白水平、UMER、血肌酐水平、临床症状积分降低,对照组治疗4周的24 h尿蛋白水平、UMER、血肌酐水平及临床症状积分降低(P<0.05)。两组治疗期间头痛、干咳、恶心、肝肾功能损伤等不良反应发生率差异无统计学意义(P>0.05)。Pearson相关分析显示,接受前列地尔联合贝那普利治疗的糖尿病肾病患者,其24 h尿蛋白水平与UMER、血肌酐水平、临床症状积分呈正相关(r=0.896,0.842,0.763,P<0.05)。结论糖尿病肾病患者尿蛋白水平与其肾功能损伤及临床症状均相关,前列地尔联合贝那普利治疗疗效和安全性良好,值得临床推广应用。

Objective To explore the effect of alprostadil dry emulsion combined with benazepril on the protein level of patients with diabetic nephropathy and its adverse reactions. Methods 66 patients with diabetic nephropathy were randomly divided into the combination group（n=33） and control group（n=33）. Control group received routine hypoglycemic agents,antihypertensive treatment, anticoagulation, and Benazepril by oral administration, while combination group was treated with Alprostadil dry emulsion on the base of the treatment routine of control group, and patients were treated for more than one treatment course. Curative effect, 24 h urine protein level, 24 h urinary microalbumin excretive rate（UMER）, serum creatinine level, clinical symptom score and incidence rate of adverse reactions during the treatment of two groups were compared, and the relationship between 24 h urine protein levels with the UMER, serum creatinine level and clinical symptom integral score were analyzed. Results Compared with control group, the proportion of marked therapeutic effect and total curative effect rate of combination group were significantly improved, and 24 h urine protein level, UMER, serum creatinine level, clinical symptom score of combination group before treatment and 2 and 4 weeks after treatment were significantly lower（P〈0.05）.Compared with those before treatment, 24 h urine protein level, UMER, serum creatinine level, clinical symptom score of combination group 2 and 4 weeks after treatment had significantly decreased, and 24 h urine protein level, UMER, serum creatinine level, clinical symptom score of control group 4 weeks after treatment had also declined（P〈0.05）. During the treatment phase, no significant differences were found in the incidence rate of adverse reactions, including headache, dry cough, nausea, liver and kidney function damage, between two groups（P〈0.05）. Pearson correlation analysis results showed that 24 h urine protein level of patients with diabetic nephropathy treated with alprostadil combined with benazepril was positively correlated with UMER, serum creatinine level and clinical symptom integral score（r=0.896, 0.842, 0.896, P〈0.05）.Conclusion Urine protein level of patients with diabetic nephropathy is associated with renal function injury and clinical symptoms. Alprostadil dry emulsion combined with benazepril has good efficacy and is safe, therefore worthy of clinical popularization and application.