摘要
目的 探讨前列地尔联合氯沙坦治疗老年糖尿病肾病(DN)的疗效及对患者血清糖化血红蛋白(HbA1c)、胱抑素C(CysC)水平及内皮素(ET-1)与一氧化氮(NO)等微循环指标的影响。方法 选取我院2020年1月至12月期间收治的老年DN患者89例,采用随机数字法分为对照组(44例)和研究组(45例)。对照组给予前列地尔治疗,研究组在此基础上给予氯沙坦钾片治疗,疗程为8周,比较两组治疗前后血清HbA1c、CysC、ET-1、NO、肌酐(Scr)、尿素氮(BUN)、24小时尿微量白蛋白定量(MALB)变化及临床总有效率。结果 治疗前,两组血清HbA1c、CysC、ET-1及NO等指标比较差异无统计学意义(P>0.05);研究组患者在治疗8周后血清HbA1c、CysC、ET-1等指标相较于治疗前明显降低,且均低于对照组,NO指标升高且高于对照组(P<0.05)。两组治疗前血清BUN、Scr及24h UmALB比较差异无统计学意义(P>0.05);治疗后,两组Scr、BUN及24h UmALB水平均显著降低(P<0.05);观察组治疗后Scr、BUN及24h UmALB水平均明显低于对照组(P<0.05)。研究组显效24例,有效19例,总有效率为95.56%,明显高于对照组(显效12例,有效22例,总有效率77.27%),比较结果具有显著性差异(P<0.05)。结论 应用前列地尔联合氯沙坦治疗老年糖尿病肾病的疗效满意,可有效降低患者血清中HbA1c、CysC水平,改善患者微循环状态和肾功能,值得临床推广应用。
Objective To investigate the efficacy of alprostadil combined with losartan in the treatment of elderly diabetic nephropathy(DN)and its effects on serum glycosylated hemoglobin(HbA1c),Cystatin C(CysC),endothelin(ET-1)and nitric oxide(NO).Methods 89 elderly DN patients treated in our hospital from January 2020 to December 2020 were selected.The control group was treated with alprostadil,and the study group was treated with losartan potassium tablets for 8 weeks.The changes of serum HbA1c,CysC,ET-1,NO,creatinine(SCR),urea nitrogen(BUN),24-hour urinary microalbumin(mAlb)and clinical total effective rate were compared between the two groups before and after treatment.Results Before treatment,there was no significant difference in serum HbA1c,CysC,ET-1 and no between the two groups(P>0.05);After 8 weeks of treatment,the indexes of serum HbA1c,CysC and ET-1 in the study group were significantly lower than those in the control group,and the indexes of no were higher than those in the control group(P<0.05).There was no significant difference in serum BUN,SCR and 24h UmALB between the two groups before treatment(P>0.05);After treatment,the levels of SCR,bun and 24h UmALB decreased significantly in the two groups(P<0.05);The levels of SCR,bun and 24h UmALB in the observation group were significantly lower than those in the control group(P<0.05).In the study group,24 cases were markedly effective,19 cases were effective,and the total effective rate was 95.56%,which was significantly higher than that in the control group(12 cases were markedly effective,22 cases were effective,and the total effective rate was 77.27%)(P<0.05).Conclusion Alprostadil combined with losartan is effective in the treatment of senile diabetic nephropathy.It can effectively reduce the serum levels of HbA1c and CysC,improve the microcirculation and renal function of patients,and is worthy of clinical application.
作者
门衡仝
MEN Hengtong(Department of Endocrinology,Tianjin Beichen hospital,Tianjin 300400,China)
出处
《中国老年保健医学》
2022年第3期53-56,共4页
Chinese Journal of Geriatric Care
关键词
前列地尔
氯沙坦
糖尿病肾病
微循环指标
疗效
alprostadil
Losartan
Diabetic nephropathy
Microcirculation index
curative effect
