瑞舒伐他汀钙联合前列地尔对糖尿病肾病患者蛋白尿的疗效观察

Therapeutic effect of rosuvastatin calcium combined with alprostadil on proteinuria in patients with diabetic nephropathy

目的观察瑞舒伐他汀钙片联合前列地尔注射液对糖尿病肾病患者蛋白尿的疗效。方法采用总结性、回顾性研究方法,选择2015年8月—2018年8月在西安西电集团医院内分泌科诊治的糖尿病肾病患者230例作为研究对象,分为对照组和观察组,每组各115例。对照组给予前列地尔注射液,10μg加入100 mL生理盐水缓慢滴注,1次/d;观察组在对照组治疗的基础上口服瑞舒伐他汀钙片10 mg,1次/d。14 d为1个疗程,两组均治疗3个疗程。观察两组的临床疗效,同时比较两组治疗前后的蛋白尿变化情况、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平、不良反应发生情况。结果治疗后,观察组与对照组的总有效率分别为98.3%和87.8%,观察组显著高于对照组(P<0.05)。治疗后,两组的24 h尿蛋白定量显著低于治疗前(P<0.05);且观察组24 h尿蛋白定量显著低于对照组(P<0.05)。治疗后,两组的IL-6、TNF-α水平均显著低于治疗前(P<0.05),且观察组炎症因子水平显著低于对照组(P<0.05)。观察组治疗期间的感染、低血糖、低蛋白血症等不良反应发生率为7.0%,对照组为8.7%,两组间差异无统计学意义。结论瑞舒伐他汀钙片联合前列地尔注射液治疗糖尿病肾病患者能更加有效降低蛋白尿含量,抑制炎性反应,提高治疗效果,安全性好。

Objective To observe the effects of Rosuvastatin Calcium Tablets combined with Alprostadil Injection on proteinuria in patients with diabetic nephropathy.Methods Using a concluding and retrospective study method,patients(230 cases)with diabetic nephropathy in the Xi’an XD GroupHospital from August 2015 to August 2018 were devided into control and observation groups,and each group had 115 cases.The control group were iv administered with Alprostadil Injection,10μg added into 100 mL normal saline,once daily.Patients in the observation group were po administered with 10 mg Rosuvastatin Calcium Tablets on the basis of control group,once daily.14 d is a course of treatment,both groups are treated for 3 courses.After treatment,the clinical efficacy was evaluated,and the 24 h urinary protein quantitation,TNF-αand IL-6 levels,and adverse reactions in two groups before and after treatment were compared.Results After treatment,the total effective rate of the observation group and the control group after treatment were 98.3%and 87.8%,respectively,and the observation group were higher than control group(P<0.05).After treatment,the 24 hour urine protein levels in two groups were significantly lower than that before treatment(P<0.05),and the 24 hour urine protein levels in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the levels of IL-6 and TNF-αin two groups were significantly lower than those before treatment(P<0.05),and the inflammatory factors levels in the observation group were also significantly lower than those in the control group(P<0.05).The incidence of adverse reactions such as infection,hypoglycemia and hypoproteinemia during the treatment in the observation group was 7.0%,and that of the control group was 8.7%,there were no significant difference compared between two groups.Conclusion Rosuvastatin Calcium Tablets combined with Alprostadil Injection in treatment of diabetic nephropathy can effectively reduce proteinuria,inhibit inflammatory response,improve the therapeutic effect,with good safety.