缬沙坦联合前列地尔对糖尿病肾病患者肾功能、血流动力学、炎性指标的影响

Effects of valsartan combined with alprostadil on renal function,hemodynamics and inflammatory indexes in patients with diabetic nephropathy

目的观察缬沙坦联合前列地尔对糖尿病肾病(DN)患者肾功能、血流动力学、炎性指标的影响。方法选取2019年3月—2020年3月宜昌市夷陵医院收治的DN患者110例,根据随机数字表法分为观察组和对照组,每组55例。在常规治疗基础上,对照组给予前列地尔注射液治疗,观察组则在对照组基础上给予缬沙坦分散片治疗,2组均治疗4周。比较2组治疗前后肾功能指标[尿素氮(BUN)、尿蛋白排泄率(UAER)、血肌酐(SCr)]、血流动力学指标[肾动脉收缩期最大血流速度(Vsmax)、舒张末期最低血流速度(Vdmin)、肾血流量(Q)、阻力指数(RI)]及炎性指标[肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、血清C反应蛋白(CRP)]。结果治疗4周后,2组BUN、UAER、SCr水平均较治疗前降低,且观察组低于对照组(P均<0.01);2组Vsmax、Vdmin、Q均较治疗前升高,RI较治疗前下降,且观察组升高/降低幅度大于对照组(P<0.05或P<0.01);2组TNF-α、IL-6、CRP水平均较治疗前降低,且观察组低于对照组(P<0.05或P<0.01)。结论缬沙坦联合前列地尔治疗DN效果确切,可显著改善患者肾功能,增强其血流动力,降低炎性反应。

Objective To explore the effects of valsartan combined with alprostadil on renal function,hemodynamics and inflammatory indexes in patients with diabetic nephropathy(DN).Methods A total of 110 DN patients admitted to Yichang Yiling Hospital from March 2019 to March 2020 were selected and divided into an observation group and a control group according to the random number table method,with 55 cases in each group.On the basis of routine treatment,the control group was given alprostadil injection,and the observation group was given valsartan dispersible tablets on the basis of the control group.Both groups were treated for 4 weeks.The changes of renal function indexes[urea nitrogen(BUN),urine protein excretion rate(UAER),serum creatinine(SCr)],hemodynamic indexes[maximum renal artery systolic blood velocity(Vsmax),minimum end-diastolic blood velocity(Vdmin),renal blood flow(Q),resistance index(RI)]and inflammatory indexes[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),serum C-reactive protein(CRP)]were compared between the two groups before and after treatment.Results After 4 weeks of treatment,the levels of BUN,UAER and SCr in both groups were lower than those before treatment,and the observation group was lower than the control group(all P<0.01);Compared with before treatment,Vsmax,Vdmin and Q in both groups were increased,RI decreased,and the increase/decrease in the observation group was greater than that in the control group(P<0.05 or P<0.01);The levels of TNF-α,IL-6 and CRP in both groups were lower than those before treatment,and the observation group was lower than the control group(P<0.05 or P<0.01).Conclusion Valsartan combined with alprostadil in the treatment of DN has an exact effect,which can significantly improve the renal function of patients,enhance their hemodynamics,and reduce the inflammatory response.