吡格列酮联合前列地尔治疗早期糖尿病肾病的临床观察

Clinical observation of pioglitazone combined with alprostadil in the treatment of early diabetic nephropathy

目的:观察吡格列酮联合前列地尔治疗早期糖尿病肾病的临床疗效。方法:64例早期糖尿病肾病随机分为治疗组、对照组各32例,在常规治疗基础上,治疗组加用吡格列酮30mg/次,1次/日口服,连服12周;静脉注射前列地尔10μg,1次/日,连续14天,停用2周后再用14天,反复3次至12周。对照组不给上述治疗。观察治疗前后尿白蛋白排泄率(UAER)、尿素氮(BUN)、血肌酐(Scr)、内生肌酐清除率(Ccr)、高敏C反应蛋白(hsCRP)、糖化血红蛋白(HbA1c)的变化。结果:治疗组12周后与治疗前比较,UAER、hsCRP、HbA1c明显下降,差异有统计学意义;两组治疗后比较,差异有统计学意义;但两组治疗前后BUN、Scr、Ccr差异无统计学意义。结论:吡格列酮联合前列地尔能减低早期糖尿病肾病的UREA,并有显著减低血糖及C反应蛋白的作用,对缓解糖尿病肾病的发生、发展有重要意义,对早期糖尿病肾病患者临床疗效满意。用药后半年随访无明显增高。

Objective:To observe the clinical effect of pioglitazone combined with alprostadil in the treatment of early diabetic nephropathy.Methods:64 patients with early diabetic nephropathy were randomly divided into the treatment group and the control group with 32 cases in each.On the basis of conventional therapy,the treatment group added pioglitazone 30mg/time,1 time/day orally for 12 weeks;the treatment group added alprostadil 10μg for intravenous injection,1 time/day,for 14 consecutive days,the drug was used again for 14 days at 2 weeks after drug withdrawal,this method was repeated 3 times until 12 weeks.The control group was not given the treatment.The changs of urinary albumin excretion rate(UAER),blood urea nitrogen(BUN),serum creatinine(Scr),creatinine clearance rate(Ccr),high sensitive C reactive protein(hsCRP),glycosylated hemoglobin(HbA1c) before and after treatment were observed.Results:Compared with before treatment,at 12 weeks after treatment,UAER,hsCRP and HbA1c were decreased significantly,the difference was statistically significant;compared the two groups after treatment,the difference was statistically significant;but BUN,Scr and Ccr of the two groups before and after treatment were no significant difference.Conclusion:Pioglitazone combined with alprostadil can reduce UREA of the early diabetic nephropathy.It has the function of significantly reducing blood glucose and C reactive protein,and has important significance for alleviating the incidence of diabetic nephropathy.The clinical curative effects of patients with early diabetic nephropathy is satisfactory.In the follow-up of half a year later after treatment,there is no significant increase.