Effect of alprostadil combined with Diammonium glycyrrhizinate on renal interstitial fibrosis in SD rats

Objective:To observe effect of alprostadil combined with Diammonium glycyrrhizinate on renal interstitial fibrosis in SD rate.Methods:A total of 75 SD rate were randomly divided into A,B,C,D,E groups with 15 in each group.Rats in group A served as the control group received just only but tissue separation without modeling operation,while model of unilateral ureteral obstruction(UUO) was established in B,C,D,E groups.Rats in A,B group were given saline lavage placebo treatment,while rats in C,D,E groups were given dianunonium glycyrrhizinate and alprostadil injection.Five rats were sacrificed 1,2,3 weeks after modeling,serum creatinine level of femoral venous blood was determined.Transforming growth factor- β1(TCF- β1) and concentration of connective tissue growth factor(CTGF) were also detected by using ELISA.Line renal interstitial tissue was taken after HE staining,renal interstitial TGF- β1 and CTGF expression were detected by using immunohistochemical method.Results:Serum creatinine levels of B,C,D,E group at different time points in were significantly higher than that of group A(P<0.05);serum creatinine levels in group B were significantly higher than that of C,D,E group at each time point(P<0.05).Serum creatinine level of Croup E was significantly lower than C,D group after 2,3 weeks(P<0.05).Rate in A group at each time point showed no significant changes in TGF- β1 and CREA concentration in serum and kidney tissues(P>0.05);while serum and kidney tissue TGF- β1,concentration of CREA.expression of rats in B,C,D,E groups showed a gradual increasing trend over time.TCF- β1 and CREF of Group B in serum and kidney tissues at each time point were significantly higher than that of the other groups(P<0.05).TCF- β1 and CREF of Group E in serum and kidney tissues at each time point were significantly lower than that of B,C,D group at all time points in serum and kidney tissues(P<0.05).Conclusions:Alprostadil combined with diammonium glycyrrhizinate can significantly lower the expression of TGF- β1 and CTGF in serum and tissues of SD rat with renal interstitial fibrosis,thus inhibit rat renal interstitial fibrosis process.It has synergy protective effect.

Effect of alprostadil in the treatment of intensive care unit patients with acute renal injury

BACKGROUND Acute kidney injury(AKI)is a sudden or rapid decline in the filtration function of the kidneys which is marked by increased serum creatinine or blood urea nitrogen.AIM To examine the value of alprostadil-assisted continuous venous-venous hemofiltration(CVVH)in the treatment of severe AKI in severely ill patients.METHODS This was a retrospective study and the inclusion criteria were as follows:(1)Age of patients(≥18 years);(2)Admission to intensive care unit due to non-renal primary disease,APACHE II score(≥18 points);(3)The diagnostic criteria of AKI guidelines were formulated with reference to the Global Organization for the Improvement of Prognosis in Kidney Diseases,with AKI grades of II-III;(4)All patients were treated with CVVH;and(5)Complete basic data were obtained for all patients.RESULTS The clinical effect of alprostadil administered in the treatment group was better than that observed in the control group(P<0.05).The urine output of patients in the alprostadil group returned to normal time(9.1±2.0 d)and was lower than that in the control group(10.6±2.5 d),the difference was statistically significant(P<0.05);adverse reactions occurred in the alprostadil group compared with the control group,but the difference was not statistically significant(P>0.05).CONCLUSION Alprostadil-assisted CVVH in the treatment of severely ill patients with AKI can effectively improve the renal resistance index and partial pressure of urine oxygen,and has a positive effect on improving renal function.

Evaluation of transurethral application of alprostadil for erectile dysfunction in Indonesians

Aim: To evaluate the efficacy and safety of transurethral application of alprostadil (MUSE^(R) ) for the treatment oferectile dysfunction in Indonesians. Methods: Twenty erectile dysfunction patients aged between 32-74 years oldwere recruited in this study. The inclusion criteria were as follows: 1) adult males 18 years or older with a subjectivecomplaint or erectile dysfunction, 2) to provide written informed consent, 3) to agree not to use other forms of treat-ment for erectile dysfunction, 4) fulfill the screening laboratory values. Part Ⅰ, eligible patients were titrated in theclinic starting with a dose of 250μg and proceed in a stepwise manner to 500 μg and 1000 μg on separate clinic visitsuntil they identified a dose that produced a satisfactory response. The interval between each in-clinic titration was 2-3days. Each in-clinic titration dose was evaluated at 15 rain intervals over a one hour period for erection assessment,blood pressure and pulse. Part 2, patients used MUSE at home for three months at the dose identified during the in-clinic titration. Monthly interim visits were required for patient follow-up and drug distribution. At the end of thestudy, patients had another laboratory (except testosterone, only assayed in screening procedure) and physical examina-tion. Results: The etiology of erectile dysfunction was psychological in 5 patients and organic in 15 patients. The65% of the patients achieved the erection scale of 4 or 5 either in the clinic or at home, 10% achieved the scale of 4at home, but not in the clinic, and 25% only achieved the scale of 2 or 3 with the highest dose of 1000 μg either in theclinic or at home. No significant differences were found in biochemical examination before and after the study. The60% of the patients who achieved erection scale 4 or 5 continued to use MUSE until the end of the study, while 40%of them complained of pain at the time of MUSE application, during erection and/or during intercourse. They withdrewfrom the study. Conclusion: Transurethral application of alprostadil (MUSE) is effective and safe to produce erec-tion sufficient for intercourse in erectile dysfunction of various etiologies. Pain during application, erection and inter-course is a common side effect and a cause of withdrawal.

Effects of alprostadil combined with lipoic acid on clinical efficacy, hemodynamics, fibronectin and plasma D-dimer in elderly patients with type 2 diabetic foot

ObjectiveTo investigate the effects of alprostadil combined with lipoic acid on clinical efficacy,hemodynamics,fibronectin and plasma D-dimer in elderly patients with type 2 diabetic foot.Methods Ninety-six elderly patients with type 2 diabetic foot hospitalized in Department of Endocrinology,Xining First People's Hospital from January 2017 to June 2019 were selected as the study subjects.They were divided into control group(48 cases)and case group(48 cases)by random number table method.The control group was treated with lipoic acid,and the case group was treated with Alprostadil for injection on the basis of the control group.The clinical efficacy,clinical symptom score,ulcer healing,hemodynamics of dorsal artery of foot,fibronectin and plasma D-two dimer in two groups were observed.Results The total effective rate of the case group was 95.83%,which was significantly higher than that of the control group(83.33%).The difference was statistically significant(P<0.05).After treatment,the pain,swelling,claudication,numbness score,ulcer area,wound PH value,plasma D-dimer level of the two groups were lower than those before treatment,and the oxygen partial pressure,blood flow velocity,vascular diameter,Resistance index(RI),pulsation index(PI)and fibronectin levels of the two groups were higher than those before treatment,the difference was statistically significant(P<0.05).The improvement of clinical efficacy,ulcer healing,dorsal pedal artery hemodynamics,fibronectin and plasma D-dimer levels in the case group were significantly better than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).ConclusionsAlprostadil combined with lipoic acid has significant clinical effect on elderly patients with type 2 diabetic foot.It can correct the abnormal hemodynamics of dorsal pedal artery,promote the healing of foot ulcer,increase the content of fibronectin ulcer tissue,reduce the level of plasma D-dimer and improve the high coagulation state.It has high efficiency and safety.It is worthy of clinical application.Further promotion.

Effects of alprostadil combined with Bailing Capsule on residual renal function, renal hemodynamics, immune indexes and nutritional status in patients with chronic renal failure

Objective:To investigate the clinical efficacy and safety of alprostadil combined with Bailing Capsule in the treatment of chronic renal failure,and the influence of alprostadil combined with Bailing Capsule on residual renal function,renal hemodynamics,immune indexes and nutritional status.Methods 86 patients with chronic renal failure(CRF)hospitalized in Wuhan integrated traditional Chinese and Western Medicine Hospital Affiliated to Tongji Medical College of Huazhong University of science and technology from January 2018 to June 2019 were selected as the study objects.They were randomly divided into control group and case group with 43 cases in each group.Two groups were given peritoneal dialysis treatment,the control group was given bailing capsule,the case group was given alprostadil injection on the basis of the control group.To observe the clinical effect of the two groups before and after treatment,and the changes of residual renal function,renal hemodynamics,immune index and nutritional status.Results The total effective rate of the case group was 97.68%,higher than 83.73%of the control group,the difference was statistically significant(P<0.05).After treatment,the levels of bun,SCR,GFR,24h urinary protein quantity,resistance index,CRP,IL-6,TNF,CD8+and SGA in the two groups were lower than those before treatment;the levels of renal blood flow,RRF,CD3+,CD4+,ALB,PA,TRF and Hb were higher than those before treatment;moreover,the improvement of serum inflammatory cytokines,residual renal function and renal hemodynamic indexes,immune indexes and nutritional status in the case group were significant The difference was statistically significant(P<0.05).The incidence of adverse reactions in the control group was 16.28%,higher than 6.98%in the case group,with no significant difference(P>0.05).Conclusion Alprostadil combined with Bailing capsule can significantly improve the residual renal function,hemodynamics,immune index,reduce the degree of inflammatory response in patients with chronic renal failure.

Alprostadil combined with tripterygium glycosides tablet in treatment of diabetic kidney disease: a systematic review and meta-analysis

Background:Diabetic kidney disease is now the principal cause of end-stage renal failure worldwide.Alprostadil combined with tripterygium glycosides tablet is a new method for diabetic kidney disease treatment.However,there are currently few systematic reviews on treatment for alprostadil combined with tripterygium glycosides tablet.Therefore,a systematic review and meta-analysis was conducted to analyze the function of alprostadil combined with tripterygium glycosides tablet in the treatment of diabetic kidney disease.Methods:We searched Pubmed,Embase,the Cochrane Library,Chinese databases,and clinical trial for randomized controlled trials of alprostadil combined with tripterygium glycosides tablet in the treatment of diabetic kidney disease,including results from the foundation of database until August 5,2020.Two reviewers have independently performed literature screening,data extraction,and quality evaluation.This meta-analysis has been carried out by RevMan5.4 software.Results:Ten randomized controlled trials with 724 patients were involved.Compared with alprostadil alone,the combination of alprostadil and tripterygium glycosides tablet in treatment of diabetic kidney disease could reduce the level of 24-hour urine protein(95%CI(–2.05,–0.22),P=0.01),serum creatinine(95%CI(–5.01,–0.20),P=0.03),level of interleukin-6(95%CI(−4.57,−2.37),P<0.00001),tumor necrosis factor-α(95%CI(−4.57,−2.37),P<0.00001).The combined treatment could also improve the clinical efficacy(95%CI(1.09,1.25),P<0.0001),and reduce the occurrence of serious adverse events(95%CI(0.26,0.94),P=0.03).However,there is no association of two treatments in blood urea nitrogen(95%CI(–4.17,2.11),P=0.52),albumin(95%CI(–1.10,0.97),P=0.90),triglyceride(95%CI(−1.44,1.50),P=0.97).Conclusion:Alprostadil combined with tripterygium glycosides tablet contributes to protecting renal function,inhibiting inflammation,and reducing the occurrence of adverse events,which could be considered as a feasible therapy for diabetic kidney disease patients.However,some clinical variables did not accurately conclude due to the low quality of methodology and small sample sizes.More rigorous and more extensive trials are essential to validate our results.Trial registration:Systematic review registration:(CRD42020203725).

Uremic clearance granule combined with Alprostadil in the treatment of chronic renal failure: A systematic review and meta-analysis

Objective: To evaluate whether the combination of Uremic clearance granule with Alprostadil is superior to Alprostadil alone for CRF. Methods: Relevant RCTs were searched through March 2019. Data were analyzed by Stata 15.0. Results: Nine articles involving 726 patients were enrolled in this study. Meta-analysis showed that the total effective rate [OR = 3.68 (2.44, 5.55), P < 0.001], Scr [SMD =-2.34 (-3.49,-1.19), P < 0.001], BUN [SMD =-1.80 (-2.73,-0.87), P < 0.001], Ccr [SMD = 0.71 (0.44, 0.97), P < 0.001] were better in the experimental group. But there were no significant difference in UA, CysC, 24h-Upro and incidence of adverse reactions (all P > 0.05) between two groups. No serious adverse reactions were found. Conclusions: The effect of the integrated medicine on CRF was better than Alprostadil alone. Uremic clearance granule is safe and has no obvious adverse reactions.

Clinical effect of Calcium Dobesilate combinated with Alprostadil in the vascular endothelium of patients with diabetic nephropathy

Objective: To research the effect of calcium dobesilate combinated with alprostadil on the changes of vascular endothelium function in patients with t diabetic nephropathy (DN), and assess the clinical effect and record the untoward effect. Method: A totoal of 120 patients with DN, then they were randomly divided into control group (n=60) and observation group(n=60). Two groups were given hypoglycemic (melbinum)+improving circulatory (calcium dobesilate), and observation group were given alprostadil on the basic, they were treated 30 days. After treatment, we observed the changes of fasting plasma glucose (FBG), 2-hour postprandial blood glucose (2hPBG), the factot of vasomotion angiokinesis (nitrogen oxide (NO), endothelin-1 (ET-1), vascular endothelial growth factor (VEGF)), diastolic function of vascular endothelium (flow mediated dilation (FMD), nitroglycerin mediated dilation (NMD)), renal function index (glomerular filtration rate (GFR), creatinine (Cr), blood urea nitrogen (BUN), albumin excrete rate (AER), urinary albumin creatinine ratio (UACR), urinary albumin evacuate ratio (UAER)), and record the untoward effect. Results: After treatment, the FBG, 2hPBG were both lower than before treatment in both groups, the difference had statistical significance (P<0.05), and the FBG, 2hPBG in the observation group were lower than the control group, and the difference had statistical significance (P<0.05). After treatment, the ET-1, VEGF were both lower than before treatment in both groups, the difference had statistical significance (P<0.05), and the ET-1, VEGF in the observation group were lower than the control group, and the difference had statistical significance (P<0.05). After treatment, the NO, FDM, NDM were higher than before treatment in both groups, the difference had statistical significance (P<0.05), and the NO, FDM, NDM in the observation group were higher than the control group, and the difference had statistical significance (P<0.05). After treatment, the GFR, Cr, BUN, AER, UACR, and UAER were both lower than before treatment in both groups, the difference had statistical significance (P<0.05), and the GFR, Cr, BUN, UACR, and UAER in the observation group were lower than the control group, and the difference had statistical significance (P<0.05). Conclusions: Treatment of the patients with DN before improving the cardiovascular system and hypoglycemic, giving the alprostadil can improve the function of vascular endothelium, rasing the clinical effect and safety.

Effects of alprostadil combined with nucleoside antiviral drugs on liver function, liver fibrosis markers and serum inflammatory factors in patients with decompensated liver cirrhosis with HBV infection

Objective:To explore the Effects of alprostadil combined with nucleoside antiviral drugs on liver function, liver fibrosis markers and serum inflammatory factors in patients with decompensated liver cirrhosis with HBV infection.Methods: 136 patients with decompensated cirrhosis of HBV infection who were hospitalized in Linxi Hospital of Kailuan General Hospital, Tangshan Infectious Disease Hospital and North China University of Technology Hospital from January to February 2018, 2017 were selected. All patients were divided into control group and case group by random number table method, 68 cases in each group. The control group was treated with routine liver protection and antiviral therapy, while the case group was treated with alprostadil on the basis of the control group. The changes of liver function, liver fibrosis, liver and spleen imaging indexes, anti-virus related indexes and inflammatory factors were observed before and after treatment in the two groups.Results: The total effective rate of the case group was 97.06%, which was significantly higher than that of the control group (85.29%), and the difference was statistically significant. The ALT, AST, TBIL, LN, HA, PCIII, CIV, portal vein diameter, spleen vein diameter, spleen thickness, IL-6, hs-CRP, TNF-α and TGF-β1 were significantly lower in the case group than in the control group. ALB, HBV DNA conversion rate, HBsAg negative rate, and HBeAg negative rate were significantly higher than the control group, the difference was statistically significant. Conclusion: Alprostadil combined with nucleoside antiviral drugs can significantly improve the decompensation of HBV infection Liver function in patients with cirrhosis, reduce the degree of liver fibrosis, inhibit the production of serum inflammatory factors, and can effectively inhibit HBV replication, clinical efficacy is significant, with certain clinical application value.

Effect of Shuxuening Injection Combined with Alprostadil on Healing of Diabetic Foot Ulcers and Hemodynamic Indexes of Dorsal Artery of Foot

OBJECTIVE: To observe the effect of Shuxuening Injection combined with alprostadil on healing of diabetic foot ulcers and hemodynamic indexes of dorsal artery of foot. METHODS: A total of 84 cases of diabetic foot patients treated in Wuhan Red Cross Hospital(from February 2016 to April 2017) were divided into treatment group(42 cases) and control group(42 cases) by the random digital table. The control group was given basic clinical treatment while the treatment group was given Shuxuening Injection combined with alprostadil on the basis of the treatment in control group. After 2 weeks of treatment, the improvement of TCM symptom scores(pain, numbness, swelling, claudication), conditions of foot ulcer healing(ulcer area, wound oxygen pressure, wound pH), the hemodynamics of the dorsum pedis artery(the blood flow velocity of the dorsum pedis artery, the blood vessel diameter, resistance index(RI), pulsation index(PI)) of both groups were compared, and the clinical efficacy of 2 groups were statistically analyzed. RESULTS: The scores of pain, numbness, swelling and claudication were significantly reduced in 2 groups after the treatment(P < 0.05), and the improvement of the above symptom scores in the treatment group were all significantly better than that in the control group(P < 0.05). The area of ulcer and the p H of the wounds in the 2 groups were significantly decreased after the treatment(P < 0.05), and the oxygen partial pressure in the wound was significantly increased(P < 0.05), and the improvements of the wound healing outcomes in the treatment group were significantly better than that in the control group(P < 0.05). The blood flow velocity of the foot, the blood vessel diameter, the level of RI and PI after treatment in both groups were significantly increased after the treatment(P < 0.05), and the improvement of the hemodynamic index of the foot back after treatment in the treatment group was significantly better than that in the control group(P < 0.05). The total effective rate of the treatment group was significantly higher than that of the control group(P < 0.05). CONCLUSION: The application of Shuxuening Injection combined with alprostadil can quickly improve the clinical symptoms of the patients, correct the abnormal hemodynamics of the dorsum pedis artery and promote the healing of foot ulcers, and the combination of the two medicines has a synergistic effect.

Effects of alprostadil on respiratory parameters and hemodynamics of newborns with persistent pulmonary hypertension

Objective: To investigate the effects of alprostadil on respiratory parameters and hemodynamics of newborns with persistent pulmonary hypertension. Methods: According to random data table method, 80 newborns of pulmonary hypertension were randomly divided into the control group (n=40) and observation group (n=40), patients in the control group were given normal frequency ventilation, on the basis of the treatment of the control group, the observation group received alprostadil. The changes of respiratory parameters and hemodynamics were compared between the two groups before and after treatment. Results:The levels of respiratory parameters (SaO2, PaO2, PaCO2) and hemodynamics (PA, PVR, SVR) in the two groups before treatment were not statistically significant. After treatment, The levels of SaO2, PaO2in the two groups were significantly higher than those in the same group before treatment, and the observation group levels were (90.71±8.92)%, (85.27±8.23) mmHg, which were significantly higher than those in the control group after treatment;The levels of PaCO2, PA, PVR and SVR in the two groups after treatment were significantly lower than those in the same group before treatment, and the observation group were (35.22±3.46) mmHg, (26.95±3.78) mmHg, (725.71±108.82) dyns/cm5, (1 125.27±152.23) dyns/cm5, which were significantly lower than that of the control group. Conclusion: Adding alprostadil based on conventional frequent ventilation thraphy can effectively improve blood pressure and oxygen saturation, and improve hemodynamics of newborns with persistent pulmonary hypertension, which has important clinical value.

Assessment of renal function and oxidative stress after alprostadil combined with valsartan treatment of early diabetic nephropathy

Objective:To analyze the renal function and oxidative stress after alprostadil combined with valsartan treatment of early diabetic nephropathy.Methods:A total of 230 patients with early diabetic nephropathy who were treated in our hospital between December 2011 and December 2015 were divided into control group (n=115) and observation group (n=115) according to random number table. Control group received valsartan treatment, observation group received alprostadil combined with valsartan treatment, and both lasted for one month. After treatment, renal blood flow parameters were evaluated by ultrasound contrast technique, renal function index levels in peripheral blood and urine were measured, and serum levels of oxidative stress indexes were detected.Results:After 1 month of treatment, area under curve (AUC) and time to peak (TTP) levels under ultrasound contrast of observation group were lower than those of control group while derived peak intensity (DPI) level was higher than that of control group;peripheral blood urea nitrogen (BUN) and serum creatinine (Scr) levels of observation group were lower than those of control group, albumin (Alb) level was higher than that of control group, and urine red blood cell (RBC) level was lower than that of control group;serum oxidative stress indexes malondialdehyde (MDA) and advanced oxidation protein products (AOPP) levels of observation group were lower than those of control group while superoxide dismutase (SOD) and total antioxidant capacity (T-AOC) levels were higher than those of control group.Conclusion: Alprostadil combined with valsartan can optimize renal function and reduce systemic oxidative stress in patients with early diabetic nephropathy.

Assessment of the renal function, peroxidation damage and inflammatory injury after epalrestat combined with alprostadil treatment of early diabetic nephropathy

Objective:To study the renal function, peroxidation damage and inflammatory injury after epalrestat combined with alprostadil treatment of early diabetic nephropathy.Methods:90 patients with early diabetic nephropathy treated in our hospital between June 2011 and November 2015 were collected and divided into observation group and control group (n=45) according to the single-blind randomized control method. Observation group received epalrestat combined with alprostadil treatment, control group received alprostadil treatment alone, and the treatment of both groups lasted for 3 months. Before treatment and after 3 months of treatment, turbidimetric immunoassay was used to detect the renal function indexes in peripheral blood, rate method was used to detect the renal function indexes in urine, and ELISA method was used to detect the levels of peroxidation indexes and inflammation indexes.Results:Before treatment, differences in renal function, peroxidation damage and inflammatory damage indexes were not statistically significant between two groups of patients (P>0.05). After 3 months of treatment, creatinine (Scr), cystatin C (CysC),β2 microglobulin (β2-MG), N-acetyl-β-D-glucosaminidase (NAG), reactive oxygen species (ROS), advanced protein oxidation products (AOPPs), interleukin-8 (IL-8), interleukin-27 (IL-27) and procalcitonin (PCT) levels of observation group were lower than those of control group while catalase (CAT), total superoxide dismutase (TSOD), interleukin-4 (IL-4), interleukin-10 (IL-10) and interleukin-13 (IL-13) levels were higher than those of control group (P<0.05). Conclusions:Epalrestat combined with alprostadil can protect the renal function and inhibit the peroxidation damage and inflammatory injury in patients with early diabetic nephropathy.

银杏叶提取物联合前列地尔对慢性阻塞性肺疾病合并肺动脉高压患者的临床疗效

目的探讨银杏叶提取物联合前列地尔对慢性阻塞性肺疾病合并肺动脉高压患者的临床疗效。方法122例患者随机分为对照组和观察组,每组61例,对照组给予前列地尔,观察组在对照组基础上加用银杏叶提取物,疗程3个月。检测临床疗效、肺功能指标(FVC、FEV_(1)、FEV_(1)/FVC)、血气指标(PaO_(2)、PaCO_(2))、PASP、mPAP、IL-6、ET-1、hs-CRP、NO、右心功能指标(RVEF、RVESD)、不良反应发生率变化。结果观察组总有效率高于对照组(P<0.05)。治疗后,2组肺功能指标、PaO_(2)、RVESD升高(P<0.05),PaCO_(2)、IL-6、ET-1、hs-CRP、NO、RVEF降低(P<0.05),以观察组更明显(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论银杏叶提取物联合前列地尔可安全有效地改善慢性阻塞性肺疾病合并肺动脉高压患者肺功能和右心功能,减轻炎症反应。

前列地尔注射液结合肠内营养支持在冠心病伴营养不良中应用

背景前列地尔注射液具有抑制血小板聚集、扩张冠状动脉、改善血液循环等作用,肠内营养支持可改善机体营养状态,提高机体免疫力,二者联合应用可能对高龄冠心病伴营养不良治疗效果更佳.目的探讨前列地尔注射液结合肠内营养支持对高龄冠心病伴营养不良中应用.方法选取2020-02/2022-02我院142例冠心病伴营养不良患者,随机数字表法分组,各71例.对照组采取常规治疗,研究组基于对照组采取前列地尔注射液结合肠内营养支持,连续治疗1 mo.统计两组左心室射血分数(left ventricular ejection fraction,LVEF)、心绞痛持续时间、心绞痛发作频率、营养状况指标[白蛋白(albumin,ALB)、转铁蛋白(transferrin,Tf)、简易营养评价表(mini-nutritional assessment,MNA)]、微炎症状态指标[微小核糖核酸-196a(miR-196a)、微小核糖核酸-146a(miR-146a)]、不良反应、主要心血管不良事件(major adverse cardiovascular events,MACE)及中国心血管患者生活质量评定问卷(china questionnaire of quality of life in patients with cardiovascular diseases,CQQC)评分.结果治疗1 mo后研究组LVEF高于对照组,心绞痛持续时间、心绞痛发作频率低于对照组(P<0.05);治疗1 mo后研究组ALB、Tf水平及MNA评分高于对照组,miR-196a、miR-146a水平低于对照组(P<0.05);两组治疗1 mo后不良反应及MACE发生率比较,差异无统计学意义;治疗1 mo后两组CQQC评分高于治疗前(P<0.05).结论前列地尔注射液结合肠内营养支持应用于高龄冠心病伴营养不良患者,有助于减轻微炎症状态,改善营养状况,控制心绞痛发作症状.

Prostaglandin E1 administration post liver transplantation and renal outcomes:A retrospective single center experience

BACKGROUND Prostaglandin E1(PGE1),or alprostadil,is a potent vasodilator that improves hepatic blood flow and reduces ischemia-reperfusion injury post-liver transplantation(LT).However,the benefits of PGE1 on renal function after LT have not yet been well described.AIM To assess the impact of PGE1 administration on renal function in patients who underwent liver or liver-kidney transplant.METHODS This retrospective study included all patients who underwent liver or liverkidney transplant at our institution from January,2011 to December,2021.Patients were classified based on whether they received PGE1.PGE1 was administered post-LT to those with transaminases>1000 U/L in the immediate postoperative period.Demographics,post-LT treatments and/or complications,renal function,and survival were analyzed.Multivariable logistic regression analysis was performed,and a two-tailed P value<0.05 was considered statistically significant.RESULTS A total of 145 patients underwent LT,with 44(30%)receiving PGE1.Baseline patient characteristics were comparable,except the PGE1 group had significantly higher aspartate aminotransferase(AST)(1961.9 U/L±1862.3 U/L vs 878 U/L±741.4 U/L,P=0.000),alanine aminotransferase(1070.6 U/L±895 U/L vs 547.7 U/L±410 U/L,P=0.000),international normalized ratio on post-LT day 1(2±0.74 vs 1.8±0.4,P=0.03),a longer intensive care unit stay(8.1 days±11.8 days vs 3.8 days±4.6 days,P=0.003),more vasopressor use(55.53 hours±111 hours vs 16.33 hours±26.3 hours,P=0.002),and higher immediate postoperative complications(18.6%vs 4.9%,P=0.04).The PGE1 group also had a significantly higher 90-day readmission rate(29.6%vs 13.1%,P=0.02)and lower 1-year liver graft survival(87.5%vs 98.9%,P=0.005).However,30-day readmission(31.6%vs 27.4%,P=0.64),LT complications(hepatic artery thrombosis,biliary complications,rejection of liver graft,cardiomyopathy),1-year patient survival(96.9%vs 97.8%,P=0.77),overall liver graft survival,and overall patient survival were similar between the two groups(95.4%vs 93.9%,P=0.74 and 88.4%vs 86.9%,P=0.81 respectively).Although the PGE1 group had a significantly lower glomerular filtration rate(eGFR)on post-LT day 7(46.3 mL/minute±26.7 mL/minute vs 62.5 mL/minute±34 mL/minute,P=0.009),the eventual need for renal replacement therapy(13.6%vs 5.9%,P=0.09),the number of dialysis sessions(0.91 vs 0.27,P=0.13),and eGFR at 1-month(37.2 mL/minute±35.9 mL/minute vs 42 mL/minute±36.9 mL/minute,P=0.49),6-months(54.8 mL/minute±21.6 mL/minute vs 62 mL/minute±21.4 mL/minute,P=0.09),and 12-months(63.7 mL/minute±20.7 mL/minute vs 62.8 mL/minute±20.3 mL/minute,P=0.85)post-LT were similar to those in the non-PGE1 group.CONCLUSION In patients who received PGE1 for ischemia-reperfusion injury,despite immediate acute renal injury post-LT,the renal function at 1-month,6-months,and 12-months post-LT was similar compared to those without ischemiareperfusion injury.Prospective clinical trials are needed to further elucidate the benefits of PGE1 use in renal function.

依帕司他联合常规药物治疗糖尿病肾病患者的效果

目的:观察依帕司他联合常规药物治疗糖尿病肾病患者的效果。方法:选取2021年1月至2023年1月该院收治的116例糖尿病肾病患者进行前瞻性研究,按照随机数字表法将其分为研究组和对照组各58例。两组均进行基础治疗,在此基础上,对照组予以常规药物(吡格列酮+前列地尔)治疗,研究组在对照组基础上联合依帕司他治疗,两组均治疗3个月。比较两组临床疗效,治疗前后肾功能指标[血肌酐(Scr)、24 h尿蛋白定量(24h UP)、血尿素氮(BUN)]水平、炎性指标[C反应蛋白(CRP)、白细胞介素-6(IL-6)]水平、氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)]水平,以及不良反应发生率。结果:研究组治疗总有效率为89.66%(52/58),高于对照组的75.86%(44/58),差异有统计学意义(P<0.05);治疗后,研究组Scr、BUN、24h UP水平均低于对照组,差异有统计学意义(P<0.05);治疗后,研究组CRP、IL-6水平均低于对照组,差异有统计学意义(P<0.05);治疗后,研究组SOD水平高于对照组,MDA水平低于对照组,差异均有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:依帕司他联合常规药物治疗糖尿病肾病患者可提高治疗总有效率,降低肾功能指标、炎性指标水平,改善氧化应激指标水平,效果优于单纯常规药物治疗。

局部亚低温联合尼莫地平及前列地尔治疗蛛网膜下腔出血后脑血管痉挛的临床效果

目的探讨蛛网膜下腔出血(SHA)后脑血管痉挛(CVS)患者采用局部亚低温联合尼莫地平及前列地尔治疗的效果。方法选择2021年4月—2023年5月济南市长清区人民医院收治的SHA后CVS患者60例为研究对象,按随机数字表法将其分为对照组及观察组,每组30例。对照组采用局部亚低温联合前列地尔治疗,观察组在对照组基础上采用尼莫地平治疗。比较两组患者的CVS发生情况、大脑动脉血流速度及临床疗效。结果观察组的CVS发生率为13.33%,低于对照组的50.00%,差异有统计学意义(P<0.05)。治疗后,观察组的大脑前动脉、中动脉及后动脉血流速度均慢于对照组,组间差异有统计学意义(P<0.05)。观察组的治疗总有效率为93.33%,高于对照组的73.33%,差异有统计学意义(P<0.05)。结论局部亚低温联合尼莫地平及前列地尔治疗SHA后CVS的效果显著,有利于减少CVS发生情况,改善大脑动脉血流速度。

高压氧辅助前列地尔对糖尿病周围神经病变患者腓肠肌神经阈值、运动和感觉神经传导速度的影响

目的探究高压氧辅助前列地尔对糖尿病周围神经病变(DPN)患者腓肠肌神经阈值、运动和感觉神经传导速度的影响。方法选取临沂市中医医院2020年9月—2023年9月收治的82例DPN患者为研究对象,按随机数字表法将其分为对照组与观察组,各41例。对照组采用前列地尔治疗,观察组在对照组基础上联合高压氧治疗,于治疗20 d后评估。比较两组的临床疗效、腓肠肌神经阈值、运动和感觉神经传导速度、不良反应发生率。结果观察组治疗总有效率较对照组高,差异有统计学意义(P<0.05)。治疗前,两组腓肠肌神经阈值、运动和感觉神经传导速度比较,组间差异无统计学意义(P>0.05);治疗后,观察组左侧、右侧腓肠肌神经阈值均较对照组低,运动及感觉神经传导速度均较对照组快,组间差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论高压氧辅助前列地尔治疗DPN患者可有效降低腓肠肌神经阈值,加快神经传导速度,且安全性高。