前列地尔单用治疗糖尿病肾病的临床疗效及其对患者胱抑素C、同型半胱氨酸水平的影响

Therapeutic effect of alprostadil alone against diabetic nephropathy and its effects on levels of glutathione C and homocysteine in patients

目的探究分析前列地尔单用对糖尿病肾病(diabetic cnephropathy,DN)患者的胱抑素C、同型半胱氨酸水平的影响及治疗价值分析。方法选取2016年10月—2017年10月间在唐山市丰润区人民医院接受治疗的早期DN患者150例,按照随机数字表法将其分为观察组和对照组,其中观察组78例,在常规治疗基础上应用前列地尔进行治疗;对照组72例,应用常规治疗方案进行治疗。治疗1个月后,观察临床疗效、治疗前后肾功能指标、血清胱抑素C、高同型半胱氨酸水平的变化及不良反应。结果观察组的临床有效率为93.59%(73/78),对照组的临床有效率为80.65%(58/72),2组比较差异有统计学意义(P<0.05)。治疗后,2组研究对象的血清胱抑素水平和同型半胱氨酸水平均显著降低(P<0.05),且观察组2种指标的含量均明显低于对照组[(0.68±0.21)mg/L vs(1.26±0.19)mg/L、(9.3±0.7)μmol/L vs(11.2±0.6)μmol/L)],差异有统计学意义(t=5.218、4.163,P<0.05)。治疗后,2组研究对象的尿素氮、尿清蛋白排泄率、内生肌酐清除率等均较治疗前变化,且观察组尿素氮和尿清蛋白排泄率均低于对照组,而内生肌酐清除率则高于对照组,差异均有统计学意义(P<0.05)。2组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论前列地尔可进一步有效地改善研究对象临床症状,提高临床治疗效果;且在改善患者肾功能,提高肾小球过滤功能,减少蛋白尿并在保护DN患者肾脏功能方面有重要价值,安全性高,值得临床推广应用。

ObjectiveTo explore the effect of alprostadil alone on the levels of glutathione C and homocysteine in patients with diabetic nephropathy and the clinical value. MethodsOne hundred and fifty patients with early diabetic nephropathy treated in our hospital between October 2016 and October 2017 were selected and divided into the observation group （n=78） and control group （n=72） using the random number table. The observation group was treated with alprostadil while receiving routine treatment, whereas the control group received conventional treatment alone. After one month of treatment, the changes of clinical efficacy, renal function indexes, serum levels of glutathione C and homocysteine, and adverse reactions were observed. ResultsThe clinical efficiency of the observation group was 93.59%（73/78）, compared to 80.65% of the control group（58/72）, so the difference was statistically significant（P〈0.05）. After treatment, the serum levels of glutathione C and homocysteine in both groups were significantly reduced（P〈0.05）, especially in the observation group[（0.68±0.21）mg/L vs（1.26±0.19）mg/L,（9.3±0.7）μmol /L vs（11.2±0.6）μmol/L], so the difference was statistically significant（t=5.218, 4.163, P〈0.05）. After treatment, the level of urea nitrogen, excretion rate of urinary albumin, and clearance rate of endogenous creatinine were significantly different in both groups. The level of urea nitrogen and excretion rate of urine albumin in the observation group were significantly lower than in the control group, but the clearance rate of endogenous creatinine was significantly higher（P〈0.05）. There was no statistically significant difference in the incidence of adverse reactions between the two groups（P〉0.05）. ConclusionAlprostadil can further alleviate the clinical symptoms of patients, enhance the clinical effect, improve renal function and glomerular filtration, and reduce proteinuria of DN patients, which is worthy of clinical application.