前列地尔联合厄贝沙坦治疗慢性肾小球肾炎的临床研究

Clinical study of alprostadil combined with irbesartan in the treatment of chronic glomerulonephritis

目的:研究前列地尔联合厄贝沙坦治疗慢性肾小球肾炎的临床效果。方法:选取2016年12月至2018年12月在我院治疗的149例慢性肾小球肾炎患者,按照随机数字表法随机分为对照组和研究组,均给予基础对症治疗,包括:纠正电解质紊乱,代谢性酸中毒,控制血压、制血脂及调节饮食等。其中,对照组患者(n=75)在上述对症治疗基础上给予厄贝沙坦片治疗(口服,150 mg Qd);研究组患者(n=74)在对照组治疗方案的基础上,加用前列地尔(静脉滴注,10μg Qd)。对照组和研究组均以2 w为1疗程,1个疗程后,停药1 w,再进行下一个疗程,共2个疗程。观察总有效率;采用全自动生化分析仪检测肾功能指标,包括:血清肌酐(Serum creatinine,SCr)、尿素氮(Bloodurea nitrogen,BUN)、尿红细胞计数(Urinary red blood cell,URBC)和24 h尿蛋白定量(Urinary protein quantification,Upro)。采用免疫比浊法检测血清高敏C-反应蛋白(High-sensitivity C-reactive protein,hs-CRP),采用酶联免疫检测血清白细胞介素-6(Interleukin-6,IL-6)和肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)。结果:研究组和对照组总有效率分别为74.67%和94.67%,差异有统计学意义(P<0.05)。经过2个疗程的治疗后,研究组和对照组患者的SCr、BUN、URBC和Upro均降低(P<0.05),而且研究组降低更为明显(P<0.05)。治疗后对照组和研究组炎性因子hs-CRP、IL-6和TNF-α均降低(P<0.05),而且研究组降低更为明显(P<0.05)。结论:前列地尔联合厄贝沙坦治疗慢性肾小球肾炎疗效确切,并能有效改善肾脏功能和免疫功能。

Objective:To investigate the clinical efficacy of alprostadil combined with irbesartan on patients with chronic glomerulonephritis.Methods:149 patients with chronic glomerulonephritisadmitted to our hospital from December2016 to December2018 were divided into the control group (75 cases) and the study group (74 cases).The control group and the study group were given basic symptomatic treatment,including correcting electrolyte disturbance,metabolic acidosis,controlling blood pressure,blood lipid production and diet regulation.The control group was orally treated with irbesartan at150 mg qd.The study group was given alprostadil (intravenous drip,10 UG qd) on the basis of the treatment plan of the control group.Both groups were treated for2weeks.After discontinued for1week,the next course of treatment was continued.The total effective rate was observed.Renal function was measured by an automatic biochemical analyzer,including serum creatinine (SCr),urea nitrogen (BUN),urinary count (URBC) and24-hour urinary protein quantification (Upro).IL-6 and TNF-alpha were detected with ELISA.Results: The total effective rates of the study group and the control group were 74.67% and 94.67%(P<0.05),respectively.After two courses of treatment,the levels of SCR,BUN,URBC and UproUpro in the study group and the control group decreased (P<0.05).And the decrease in the study group was more significant than the control group (P<0.05).After treatment,the inflammatory factors hs-CRP,IL-6,and TNF-alpha in the control group and the study group were all decreased (P<0.05).And the decrease in the study group was more obvious than the control group (P<0.05).Conclusion: Alprostadil combined with irbesartan is effective in the treatment of chronic glomerulonephritis,whichcan effectively improve renal function and immune function.