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目的探讨前列地尔序贯疗法联合复方丹参滴丸对老年临床糖尿病肾病的治疗效果。方法将老年糖尿病肾病患者80例,随机分为对照组和观察组,每组40例。对照组给予常规治疗+复方丹参滴丸(治疗4周);观察组在对照组的基础上给予前列地尔序贯治疗(前列地尔注射液2周,贝前列素钠片2周)。对2组患者治疗前后总蛋白、血栓素B2、肾血流、24 h尿微量白蛋白(UMA)以及尿6-酮-前列素F1α(6-keto-PGF1α)进行观察。结果治疗后,两组总蛋白和UMA水平显著降低,观察组总蛋白和UMA水平显著低于对照组(P<0.05);两组肾脏动脉、段动脉及叶间动脉阻力指数(RI)显著降低,观察组RI显著低于对照组(P<0.05);两组6-keto-PGF1α显著升高,观察组6-keto-PGF1α水平显著高于对照组(P<0.05);两组血栓素B2显著降低,观察组血栓素B2显著低于对照组(P<0.05)。结论前列地尔序贯疗法联合复方丹参滴丸可有降低老年临床糖尿病肾病患者尿蛋白水平,改善患者血流动力学。
Objective To investigate the effect of sequential administration of alprostadil combined with compound Danshen dripping pills on clinical diabetic nephropathy in the elderly. Methods 80 elderly diabetic nephropathy patients were randomly divided into control group and observation group, 40 cases in each group. The control group was given routine treatment + compound Danshen dripping pills (for 4 weeks). The observation group was given alprostadil sequential treatment (alprostadil injection for 2 weeks and beraprost sodium tablets for 2 weeks) on the basis of the control group. The total protein, thromboxane B2, renal blood flow, 24 h urine microalbuminuria (UMA) and urinary 6-keto-PGF1α were observed before and after treatment in both groups. Results After treatment, the levels of total protein and UMA in the two groups were significantly decreased, and the levels of total protein and UMA in the observation group were significantly lower than those in the control group (P <0.05). The RI of the renal arteries, the segmental arteries and the interlobar arteries were significantly decreased , And the RI in the observation group was significantly lower than that in the control group (P <0.05). The levels of 6-keto-PGF1α in the two groups were significantly increased and the levels of 6-keto-PGF1α in the observation group were significantly higher than those in the control group (P <0.05). The thromboxane B2 in the observation group was significantly lower than that in the control group (P <0.05). Conclusions Alprostadil sequential therapy combined with compound Danshen dripping pills can reduce urinary protein levels in elderly patients with diabetic nephropathy and improve hemodynamics.