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目的探究氯吡格雷联合前列地尔治疗早期糖尿病肾病的临床效果。方法选择2015年3月—2017年4月收治的早期糖尿病肾病患者96例,按照随机数字表法将其分为观察组和对照组各48例。对照组予以前列地尔注射液治疗,观察组在对照组的基础上予以氯吡格雷治疗。比较两组尿微量白蛋白量(U-malb)、尿β2-微球蛋白(β2-MG)、高敏C反应蛋白(hs-CRP)、全血粘滞度、血浆粘滞度、血小板聚集率、尿素氮(BUN)、血肌酐(Cr)、平均动脉压(MPA)的变化及治疗期间不良反应发生情况。计量资料比较采用t检验,计数资料比较采用χ~2检验,P<0.05为差异有统计学意义。结果治疗后,观察组U-malb、β2-MG、hs-CRP水平均低于对照组,差异具有统计学意义(均P<0.05);观察组全血低切比粘度、全血高切比粘度、血浆粘度、血小板聚集率均低于对照组,差异具有统计学意义(均P<0.05);观察组与对照组BUN、Cr、MPA水平比较,差异无统计学意义(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)。结论氯吡格雷联合前列地尔治疗早期糖尿病肾病安全性较高,能有效减轻炎症反应、降低尿蛋白水平、改善血液流变学指标。
Objective To investigate the clinical efficacy of clopidogrel combined with alprostadil in the treatment of early diabetic nephropathy. Methods Ninety-six patients with early diabetic nephropathy admitted from March 2015 to April 2017 were divided into observation group (48 cases) and control group (48 cases) according to random number table method. The control group was treated with alprostadil injection, and the observation group was given clopidogrel on the basis of the control group. The urinary albumin, urine β2-microglobulin, hs-CRP, whole blood viscosity, plasma viscosity, platelet aggregation rate , BUN, Cr and MPA, and the adverse reactions during treatment. Measurement data were compared using t test, count data were compared using χ ~ 2 test, P <0.05 for the difference was statistically significant. Results After treatment, the levels of U-malb, β2-MG and hs-CRP in the observation group were significantly lower than those in the control group (all P <0.05) Viscosity, plasma viscosity and platelet aggregation rate were lower than the control group, the difference was statistically significant (P <0.05). There was no significant difference in the levels of BUN, Cr and MPA between the observation group and the control group (P> 0.05). The incidence of adverse reactions in the two groups, the difference was not statistically significant (P> 0.05). Conclusion Clopidogrel combined with alprostadil is safe for treatment of early stage diabetic nephropathy, which can effectively reduce the inflammatory reaction, reduce the level of urinary protein and improve the indexes of hemorheology.