CAJ | 학술논문

目的：探讨贝前列腺素钠对早期糖尿病肾病患者尿白蛋白排泄率、血清胱抑素C及血管内皮功能的影响。方法选择早期糖尿病肾病患者58例，按随机数字表法分为对照组30例和治疗组28例。对照组予低蛋白饮食、人胰岛素控制血糖、控制血压等常规治疗；治疗组在常规治疗的基础上使用贝前列腺素钠40μg，口服3次/d，共使用12周。检测早期糖尿病肾病患者治疗前后糖化血红蛋白（ HbA1c）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、24 h尿白蛋白排泄率（24h UAER）、血清胱抑素C（Cys-C）、内生肌酐清除率（Ccr）、血内皮素-1（ET-1）水平，同时利用超声检测肱动脉血流介导的内皮依赖性血管舒张功能（ FMD）。结果两组患者治疗前后血糖、血压、血脂等指标比较差异无统计学意义（ P＞0.05），治疗组患者治疗后24 h UAER、血清Cys-C、ET-1较对照组显著降低，Ccr、内皮依赖性血管舒张功能（ FMD）较对照组显著升高，差异均有统计学意义（ P均＜0.05）。结论贝前列腺素钠有效地降低早期糖尿病肾病患者的血清Cys-C及24h UAER水平，并改善血管内皮功能。
목적：탐토패전렬선소납대조기당뇨병신병환자뇨백단백배설솔、혈청광억소C급혈관내피공능적영향。방법선택조기당뇨병신병환자58례，안수궤수자표법분위대조조30례화치료조28례。대조조여저단백음식、인이도소공제혈당、공제혈압등상규치료；치료조재상규치료적기출상사용패전렬선소납40μg，구복3차/d，공사용12주。검측조기당뇨병신병환자치료전후당화혈홍단백（ HbA1c）、감유삼지（TG）、총담고순（TC）、고밀도지단백담고순（HDL-C）、저밀도지단백담고순（LDL-C）、24 h뇨백단백배설솔（24h UAER）、혈청광억소C（Cys-C）、내생기항청제솔（Ccr）、혈내피소-1（ET-1）수평，동시이용초성검측굉동맥혈류개도적내피의뢰성혈관서장공능（ FMD）。결과량조환자치료전후혈당、혈압、혈지등지표비교차이무통계학의의（ P＞0.05），치료조환자치료후24 h UAER、혈청Cys-C、ET-1교대조조현저강저，Ccr、내피의뢰성혈관서장공능（ FMD）교대조조현저승고，차이균유통계학의의（ P균＜0.05）。결론패전렬선소납유효지강저조기당뇨병신병환자적혈청Cys-C급24h UAER수평，병개선혈관내피공능。
Objective To investigate the effect of the beraprost sodium on serum cystatin C, urinary mi-croalbumin excretion rate and vascular endothelial function in patients with early diabetic nephropathy .Methods Fif-ty-eight patients with early diabetic nephropathy were selected and randomly divided into 2 groups(control group with 30 cases and treatment group with 28 cases).Control group was treated with insulin,low-protein diet,control blood pressure;the treatment group was treated with beraprost sodium 40 μg tid on the basis of normal treatment for 12 weeks.The endothelium-dependent flow-mediated dilatation(FMD) of brachial artery was determined with ultrasound , and the levels of endothelin-1(ET-1), Glycated hemoglobin(HbA1c), triglycerides(TG), total cholesterol(TC), high-density lipoprotein cholesterol ( HDL-C) , low density lipoprotein cholesterol ( LDL-C) , 24 h urinary albumin ex-cretion rate(UAER), serum cystatin C(Cys-C), endogenous creatinine clearance (Ccr) were measured respectively before and after treatment .Results There was no statistically significant difference of blood sugar ,blood pressure, blood lipid before and after treatment (P>0.05).After treatment,the levels of UAER, Cys-c and ET-1 in treatment group were significantly lower than those of the control group ( P<0.05 ) , the levels of Ccr and FMD in treatment group were increased more significantly than control group ( P<0.05 ) .Conclusion The beraprost sodium can effec-tively reduce the levels of UAER , Cys-C and recovery renal vascular endothelial function in the patients with early di -abetic nephropathy .