前列地尔联联合胰激肽原酶对糖尿病肾病尿微量白蛋白肌酐比值的影响
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摘要
目的:探讨前列地尔联和胰激肽原酶针对糖尿病肾病尿微量白蛋白肌酐比值(U-mAlb/Cr)的影响。方法:选择某院收治的糖尿病肾病患者104例,按随机双盲法分为2组,每组各52例。对照组给予胰激肽原酶针肌肉注射,观察组在对照组基础上给予前列地尔静脉滴注。比较2组患者临床疗效、肾功能指标、U-mAlb/Cr、脂联素、内脂素、β2微球蛋白(β2-MG)水平及不良反应情况。结果:观察组总有效率(92. 31%)高于对照组(69. 23%),差异有统计学意义(P <0. 05);治疗2周后,2组患者血清胱抑素(Cys C)、血尿素氮(BUN)、U-mAlb/Cr、脂联素、内脂素及β2-MG均降低,观察组低于对照组,差异有统计学意义(P <0. 05);治疗期间,不良反应发生率观察组(13. 46%)与对照组(9. 62%)比较,差异无统计学意义(P> 0. 05)。结论前列地尔联合胰激肽原酶治疗糖尿病肾病疗效确切,可有效改善患者肾功能及尿蛋白排泄率,延缓肾病进展,值得临床推广。
Objective: To investigate the effect of alprostadil combined with pancreatic kininogenase injection on urine microalbuminuria/creatinine( U-mAlb/Cr) in patients with diabetic nephropathy. Methods: 104 patients with diabetic nephropathy were selected and randomly divided into two groups,with 52 cases in each group. The control group was given intramuscular injection of pancreatic kininogenase,while the observation group was given intravenous drip of alprostadil based on the regime of the control group. The clinical efficacy,renal function indexes,U-mAlb/Cr,adiponectin,visfatin,β2-microglobulin( β2-MG),and adverse reactions were compared between the two groups. Results: The total effective rate of the observation group( 92. 31%) was higher than that of the control group( 69. 23%)( P < 0. 05). Two weeks after the treatment,serum cystatin( Cys C),blood urea nitrogen( BUN),U-mAlb/Cr,adiponectin,visfatin,and β2-MG in both groups decreased,and the observation group was lower than the control group in the indexes concerned( P < 0. 05). During the treatment,there was no statistical difference in the incidence of adverse reactions between the observation group( 13. 46%) and the control group( 9. 62%)( P > 0. 05). Conclusion: Alprostadil combined with pancreatic kininogenase injection in treatment of diabetic nephropathy is effective. It can improve renal function and urinary protein excretion rate,delay the progression of diabetic nephropathy,and is worthy of clinical promotion.
Objective: To investigate the effect of alprostadil combined with pancreatic kininogenase injection on urine microalbuminuria/creatinine( U-mAlb/Cr) in patients with diabetic nephropathy. Methods: 104 patients with diabetic nephropathy were selected and randomly divided into two groups,with 52 cases in each group. The control group was given intramuscular injection of pancreatic kininogenase,while the observation group was given intravenous drip of alprostadil based on the regime of the control group. The clinical efficacy,renal function indexes,U-mAlb/Cr,adiponectin,visfatin,β2-microglobulin( β2-MG),and adverse reactions were compared between the two groups. Results: The total effective rate of the observation group( 92. 31%) was higher than that of the control group( 69. 23%)( P < 0. 05). Two weeks after the treatment,serum cystatin( Cys C),blood urea nitrogen( BUN),U-mAlb/Cr,adiponectin,visfatin,and β2-MG in both groups decreased,and the observation group was lower than the control group in the indexes concerned( P < 0. 05). During the treatment,there was no statistical difference in the incidence of adverse reactions between the observation group( 13. 46%) and the control group( 9. 62%)( P > 0. 05). Conclusion: Alprostadil combined with pancreatic kininogenase injection in treatment of diabetic nephropathy is effective. It can improve renal function and urinary protein excretion rate,delay the progression of diabetic nephropathy,and is worthy of clinical promotion.
引文
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[8]黄岩,孙程宽,胡光瑞,等.尿微量白蛋白水平在高血压、糖尿病肾病患者诊断中的临床价值[J].中国实验诊断学,2018,22(8):1408-1409.
[9]汪志红,何慈江.糖尿病肾病早期生物标志物预测肾病进展的可靠性[J].中华糖尿病杂志,2018,10(4):251-255.
[10]陈海兰,郭海霞.生物标志物在糖尿病肾病早期检测中研究进展[J].中国医师杂志,2018,20(5):796-799.
[11]王尔萍,韩林.血清ANCA、ACLA联合β2-MG对早期糖尿病肾病诊断的临床价值[J].医学研究杂志,2018,47(5):52-54,59.
[12]古丽娜孜·吐尔逊,周迪军.胰激肽原酶对糖尿病肾病临床期患者肾功能及血流动力学的影响[J].中国医学装备,2017,14(3):97-100.
[13]张飞娟,陈晨,冯淑芝,等.胰激肽原酶对糖尿病肾病患者肾功能及血流动力学的影响[J].山东医药,2016,56(6):73-75.
[14]刘超,李强,吴伟利,等.静脉注射前列地尔对糖尿病肾病病人PCI术后肾功能的保护作用[J].中西医结合心脑血管病杂志,2017,15(18):2352-2354.
[15]刘玉才,徐飞.前列地尔治疗糖尿病肾病的机制及临床应用[J].中国老年学杂志,2016,36(2):500-501.
[2]严琳玲,刘文娟,陆晓兰,等.胰激肽原酶对2型糖尿病小鼠肾小管病变的保护作用及机制[J].中华糖尿病杂志,2014,6(12):887-892.
[3]石冰青.前列地尔在糖尿病肾病中的研究进展[J].临床与病理杂志,2017,37(12):2709-2716.
[4]葛均波,徐永健.内科学[M]. 8版.北京:人民卫生出版社,2013:490-493.
[5]中华医学会糖尿病学分会微血管并发症学组.糖尿病肾病防治专家共识(2014年版)[J].中国糖尿病杂志,2014,6(11):792-801.
[6]娄群,陈兆杰,姜琦,等.老年糖尿病肾病发病机制、诊断及治疗的研究进展[J].中国老年学杂志,2018,38(1):244-247.
[7]张雪莲,汪伟,汪仁斌,等.糖尿病周围神经病与糖尿病肾病的相关性分析[J].中国医刊,2018,53(6):606-609.
[8]黄岩,孙程宽,胡光瑞,等.尿微量白蛋白水平在高血压、糖尿病肾病患者诊断中的临床价值[J].中国实验诊断学,2018,22(8):1408-1409.
[9]汪志红,何慈江.糖尿病肾病早期生物标志物预测肾病进展的可靠性[J].中华糖尿病杂志,2018,10(4):251-255.
[10]陈海兰,郭海霞.生物标志物在糖尿病肾病早期检测中研究进展[J].中国医师杂志,2018,20(5):796-799.
[11]王尔萍,韩林.血清ANCA、ACLA联合β2-MG对早期糖尿病肾病诊断的临床价值[J].医学研究杂志,2018,47(5):52-54,59.
[12]古丽娜孜·吐尔逊,周迪军.胰激肽原酶对糖尿病肾病临床期患者肾功能及血流动力学的影响[J].中国医学装备,2017,14(3):97-100.
[13]张飞娟,陈晨,冯淑芝,等.胰激肽原酶对糖尿病肾病患者肾功能及血流动力学的影响[J].山东医药,2016,56(6):73-75.
[14]刘超,李强,吴伟利,等.静脉注射前列地尔对糖尿病肾病病人PCI术后肾功能的保护作用[J].中西医结合心脑血管病杂志,2017,15(18):2352-2354.
[15]刘玉才,徐飞.前列地尔治疗糖尿病肾病的机制及临床应用[J].中国老年学杂志,2016,36(2):500-501.