摘要
Abstract
Objective To explore the clinical efficacy and safety of beraprost sodium tablets combined with alprostadil injection in patients with stage Ⅲ diabetic nephropathy.Methods According to queuing method,inpatients with stage Ⅲ diabetic nephropathy treated in the hospital were divided into treatment group and control group.Treatment group was treated with beraprost sodium tablets+alprostadil injection(the first 2 weeks:intravenous drip of alprostadil injection 10 μg qd.the last 2 weeks:oral beraprost sodium tables 40 μg tid),while control group was treated with alprostadil injection(the same administration method as treatment group for 4 weeks).The clinical efficacy,β2 microglobulin(β2-MG),cystatin C(Cys-C),blood urea nitrogen(BUN),serum creatinine(SCr),urinary albumin to creatinine ratio(UACR),transforming growth factor β1(TGF-β1),tissue inhibitor of metalloproteinase-1(TIMP-1),matrix metalloproteinase-9(MMP-9),hemoglobin Alc(HbAlc),fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PBG),homeostasis model assessment for insulin resistance(HOMA-IR),hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor α(TNF-α)and interleukin-6(IL-6)were compared between the two groups,and the safety was evaluated.Results Among the 103 patients,there were 52 cases in treatment group and 51 cases in control group.The efficiency rate in treatment group was higher than that in control group[92.31％(48 cases/52 cases)vs.78.43％(40 cases/51 cases),P＜0.05].After treatment,levels of serum β2-MG in treatment group and control group were(0.25±0.06)and(0.31±0.07)mg·L-1,BUN levels were(5.70±0.91)and(6.89±1.01)mmol·L-1,SCr levels were(85.46±8.89)and(93.88±9.77)μmol·L-1,Cys-C levels were(1.38±0.26)and(1.64±0.30)mg·L-1,UACR levels were(140.24±31.04)and(176.40±36.19)mg·g-1,respectively;levels of serum TIMP-1 were(88.34±12.36)and(97.62±15.44)ng·mL-1,TGF-β1 levels were(112.49±17.24)and(138.50±19.84)ng·mL-1,MMP-9 levels were(130.69±21.30)and(114.79±19.77)μ.g·L-1,respectively;levels of serum IL-6 were(141.49±28.85)and(173.49±32.36)pg·mL-1,hs-CRP levels were(7.64±1.16)and(9.29±1.54)mg·L-1,TNF-α levels were(23.65±4.34)and(29.12±3.86)pg·mL-1,and differences in the above indexes between treatment group and control group were all statistically significant(all P＜0.05).During treatment,there was 1 case with diarrhea,1 case with rash and 1 case with nausea and vomiting in treatment group,while there was 1 case with rash and 1 case with diarrhea in control group.There was no statistically significant difference in incidence of adverse drug reactions between treatment group and control group(5.77％vs.3.92％,P＞0.05).Conclusion Alprostadil injection combined with beraprost sodium tablets can effectively improve renal function,regulate metabolism of extracellular matrixes in renal tissues,relieve inflammatory response and improve clinical curative effect in patients with stage Ⅲ diabetic nephropathy.关键词
贝前列素钠片/前列地尔注射液/糖尿病肾病/肾功能/胰岛素抵抗指数Key words
beraprost sodium tablet/alprostadil injection/diabetic nephropathy/renal function/homeostasis model assessment for insulin resistance分类
医药卫生
