中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2011年
10期
1062-1065
,共4页
王彦敏%孙志芬%邵鹏%邢喜芝%李朋霞%刘金鹏%王海涛
王彥敏%孫誌芬%邵鵬%邢喜芝%李朋霞%劉金鵬%王海濤
왕언민%손지분%소붕%형희지%리붕하%류금붕%왕해도
糖尿病肾病%超敏C反应蛋白%胱抑素%依那普利%前列地尔
糖尿病腎病%超敏C反應蛋白%胱抑素%依那普利%前列地爾
당뇨병신병%초민C반응단백%광억소%의나보리%전렬지이
Diabetic nephropathy%High sensitive C-reactive protein%Cystatin%Enalapril%Alprostadil
目的 评价前列地尔联合依那普利在治疗早期糖尿病肾病中对血清超敏C-反应蛋白(hs-CRP)及胱抑素(Cysc)的影响.方法 收集门诊患者115例,随机分成3组:前列地尔组37例,给予前列地尔10μg+生理盐水100 ml,静脉滴注,1次/d；依那普利组38例,给予依那普利5mg,2次/d；联合治疗组40例,给予前列地尔10μg+生理盐水100 ml,静脉滴注,1次/d,联合依那普利5 mg,2次/d；全部病例观察12周,分别比较3组血压、血糖、糖化血红蛋白(HbA1c)、24h尿微量白蛋白(24 hUAE)、Hs-CRP 及CysC的变化.结果 治疗后3组中hs-CRP、CysC及24 hUAE均较前明显好转:前列地尔组hs-CRP [(7.86±1.16) mg/L与(8.44±1.13) mg/L,t=2.1785]、CysC[(1.26±0.19) mg/L与(1.36±0.21)mg/L,t=2.1478]、24 hUAE[ (242.19±24.68) mg/24 h与(256.32±32.40) mg/24 h,t=2.1102],依那普利组hs-CRP[(7.81±1.13) mg/L与(8.46±1.45) mg/L,t=2.1796]、CysC[(1.29±0.21) mg/L与( 1.40±0.23) mg/L,t=2.1772]、24 hUAE[( 231.00±29.45) mg/24h与(246.79±32.59) mg/24h,t=2.2159],联合治疗组hs-CRP[ (7.30±1.12) mg/L与(8.43±2.34) mg/L,t=4.0922]、CysC[ (1.17±0.18) mg/L与(1.38±0.19) mg/L,t =5.0746]、24 hUAE[ (218.76±22.10) mg/24 h与(251.56±34.16)mg/24 h,t=3.3888],与治疗前比较差异均有统计学意义(P均＜0.05).联合治疗组hs-CRP、CysC及24hUAE治疗后较另外2组改善更明显:联合组与前列地尔组比较hs-CRP[ (7.30±1.12) mg/L与(7.86±1.16)mg/L,t=2.1547]、CysC[(1.17±0.18) mg/L与(1.26±0.19) mg/L,t=2.1343]、24 hUAE[ (218.76±22.10) mg/24 h与(242.19±24.68) mg/24 h,=2.3317]差异均有统计学意义(P均＜0.05)；联合组与依那普利组比较hs-CRP[ (7.30±1.12) mg/L与(7.81±1.13) mg/L,t=2.0014]、CysC[(1.17±0.18) mg/L与(1.29±0.21) mg/L,t=3.4455]、24 hUAE[(218.76±22.10) mg/24 h与(231.00±29.45) mg/24 h,t=2.0830]差异均有统计学意义(P均＜0.05).结论 前列地尔联合依那普利治疗早期糖尿病肾病是临床有效的方法,且能降低血清hs-CRP及血清CysC浓度.
目的 評價前列地爾聯閤依那普利在治療早期糖尿病腎病中對血清超敏C-反應蛋白(hs-CRP)及胱抑素(Cysc)的影響.方法 收集門診患者115例,隨機分成3組:前列地爾組37例,給予前列地爾10μg+生理鹽水100 ml,靜脈滴註,1次/d；依那普利組38例,給予依那普利5mg,2次/d；聯閤治療組40例,給予前列地爾10μg+生理鹽水100 ml,靜脈滴註,1次/d,聯閤依那普利5 mg,2次/d；全部病例觀察12週,分彆比較3組血壓、血糖、糖化血紅蛋白(HbA1c)、24h尿微量白蛋白(24 hUAE)、Hs-CRP 及CysC的變化.結果 治療後3組中hs-CRP、CysC及24 hUAE均較前明顯好轉:前列地爾組hs-CRP [(7.86±1.16) mg/L與(8.44±1.13) mg/L,t=2.1785]、CysC[(1.26±0.19) mg/L與(1.36±0.21)mg/L,t=2.1478]、24 hUAE[ (242.19±24.68) mg/24 h與(256.32±32.40) mg/24 h,t=2.1102],依那普利組hs-CRP[(7.81±1.13) mg/L與(8.46±1.45) mg/L,t=2.1796]、CysC[(1.29±0.21) mg/L與( 1.40±0.23) mg/L,t=2.1772]、24 hUAE[( 231.00±29.45) mg/24h與(246.79±32.59) mg/24h,t=2.2159],聯閤治療組hs-CRP[ (7.30±1.12) mg/L與(8.43±2.34) mg/L,t=4.0922]、CysC[ (1.17±0.18) mg/L與(1.38±0.19) mg/L,t =5.0746]、24 hUAE[ (218.76±22.10) mg/24 h與(251.56±34.16)mg/24 h,t=3.3888],與治療前比較差異均有統計學意義(P均＜0.05).聯閤治療組hs-CRP、CysC及24hUAE治療後較另外2組改善更明顯:聯閤組與前列地爾組比較hs-CRP[ (7.30±1.12) mg/L與(7.86±1.16)mg/L,t=2.1547]、CysC[(1.17±0.18) mg/L與(1.26±0.19) mg/L,t=2.1343]、24 hUAE[ (218.76±22.10) mg/24 h與(242.19±24.68) mg/24 h,=2.3317]差異均有統計學意義(P均＜0.05)；聯閤組與依那普利組比較hs-CRP[ (7.30±1.12) mg/L與(7.81±1.13) mg/L,t=2.0014]、CysC[(1.17±0.18) mg/L與(1.29±0.21) mg/L,t=3.4455]、24 hUAE[(218.76±22.10) mg/24 h與(231.00±29.45) mg/24 h,t=2.0830]差異均有統計學意義(P均＜0.05).結論 前列地爾聯閤依那普利治療早期糖尿病腎病是臨床有效的方法,且能降低血清hs-CRP及血清CysC濃度.
목적 평개전렬지이연합의나보리재치료조기당뇨병신병중대혈청초민C-반응단백(hs-CRP)급광억소(Cysc)적영향.방법 수집문진환자115례,수궤분성3조:전렬지이조37례,급여전렬지이10μg+생리염수100 ml,정맥적주,1차/d；의나보리조38례,급여의나보리5mg,2차/d；연합치료조40례,급여전렬지이10μg+생리염수100 ml,정맥적주,1차/d,연합의나보리5 mg,2차/d；전부병례관찰12주,분별비교3조혈압、혈당、당화혈홍단백(HbA1c)、24h뇨미량백단백(24 hUAE)、Hs-CRP 급CysC적변화.결과 치료후3조중hs-CRP、CysC급24 hUAE균교전명현호전:전렬지이조hs-CRP [(7.86±1.16) mg/L여(8.44±1.13) mg/L,t=2.1785]、CysC[(1.26±0.19) mg/L여(1.36±0.21)mg/L,t=2.1478]、24 hUAE[ (242.19±24.68) mg/24 h여(256.32±32.40) mg/24 h,t=2.1102],의나보리조hs-CRP[(7.81±1.13) mg/L여(8.46±1.45) mg/L,t=2.1796]、CysC[(1.29±0.21) mg/L여( 1.40±0.23) mg/L,t=2.1772]、24 hUAE[( 231.00±29.45) mg/24h여(246.79±32.59) mg/24h,t=2.2159],연합치료조hs-CRP[ (7.30±1.12) mg/L여(8.43±2.34) mg/L,t=4.0922]、CysC[ (1.17±0.18) mg/L여(1.38±0.19) mg/L,t =5.0746]、24 hUAE[ (218.76±22.10) mg/24 h여(251.56±34.16)mg/24 h,t=3.3888],여치료전비교차이균유통계학의의(P균＜0.05).연합치료조hs-CRP、CysC급24hUAE치료후교령외2조개선경명현:연합조여전렬지이조비교hs-CRP[ (7.30±1.12) mg/L여(7.86±1.16)mg/L,t=2.1547]、CysC[(1.17±0.18) mg/L여(1.26±0.19) mg/L,t=2.1343]、24 hUAE[ (218.76±22.10) mg/24 h여(242.19±24.68) mg/24 h,=2.3317]차이균유통계학의의(P균＜0.05)；연합조여의나보리조비교hs-CRP[ (7.30±1.12) mg/L여(7.81±1.13) mg/L,t=2.0014]、CysC[(1.17±0.18) mg/L여(1.29±0.21) mg/L,t=3.4455]、24 hUAE[(218.76±22.10) mg/24 h여(231.00±29.45) mg/24 h,t=2.0830]차이균유통계학의의(P균＜0.05).결론 전렬지이연합의나보리치료조기당뇨병신병시림상유효적방법,차능강저혈청hs-CRP급혈청CysC농도.
Objective To evaluate the effects of Alprostadil combined with Enalapril on high sensitivity C-reactive protein and Cystatin in patients with early diabetic nephropathy.Methods One hundred and fifteen cases of outpatients were randomized into 3 groups.Thirty-seven cases were assigned to Alprostadil group and treated with Alprostadil 10 μg + NS 100 ml,iv,qid;Thirty-eight cases were assigned to the Analapril group and treated with Enalapril 5 mg bid;Forty cases were assigned to the combined treatment group and treated with Alprostadil 10 μg + NS 100 ml,iv qid and Enalapril 5mg bid.All patients were observed for twelve weeks.Changes before and after treatment in the blood pressure,plasma glucose,glycolated hemoglobin (HbA1 c),24 hours urinary albumin (24 hUAE),high-sensitive C-reactive protein(hs-CRP) and Cystain C( Cys C) were observed and compared between the three groups.Results After treatment,hs-CRP,CysC and 24 h UAE were significantly improved in the three groups compared with baseline levels( P ＜ 0.05).In the combined treatment group,hs-CRP,CysC and 24 h UAER had a more significant improvement than the other two groups (P ＜0,05 ).Conclusion Alprostadil combined with Enalapril is a clinically effective strategy in the treatment of early diabetic nephropathv and can reduce the levels of CysC and hs-CRP.
