中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
1期
11-13
,共3页
付文静%吴靖林%张沛%贾强
付文靜%吳靖林%張沛%賈彊
부문정%오정림%장패%가강
前列地尔%高血压,肾性%早期诊断
前列地爾%高血壓,腎性%早期診斷
전렬지이%고혈압,신성%조기진단
Alprostadil%Hypertension,renal%Early diagnosis
目的 观察静脉注射前列腺素E1对高血压合并微量白蛋白尿患者肾小球及肾小管功能的改善作用.方法 选取60例高血压合并微量白蛋白尿及夜尿增多患者,进入研究前已接受氯沙坦钾治疗12周以上,按随机数字表法分为治疗组和对照组,每组30例.治疗组和对照组原有降压药物均继续服用,治疗组给予前列腺素E1治疗3个疗程,同时常规使用氯沙坦钾及其他降压药物,采用自身治疗前后对比及与对照组对比,观察患者前列腺素E1治疗前后尿微量白蛋白(mALB)、尿渗透浓度、尿β2微球蛋白(β2-MG)及尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)的变化情况.结果 两组治疗后血压均下降,但与治疗前比较差异无统计学意义(P＞0.05).治疗组治疗后12周尿mALB、尿β2-MG及尿NAG均低于对照组[(88.6±14.2)μg/min比(123.9± 14.8) μg/min、(0.84±0.41)mg/L比(1.61±0.49) mg/L、(30.2±10.5) U/L比(75.7±12.8) U/L],尿渗透浓度高于对照组[(591±71) mmol/L比(454±67) mmol/L],差异均有统计学意义(P＜0.01).结论 前列腺素E1可减轻早期高血压肾脏损害患者肾脏缺血状态,改善肾脏功能.
目的 觀察靜脈註射前列腺素E1對高血壓閤併微量白蛋白尿患者腎小毬及腎小管功能的改善作用.方法 選取60例高血壓閤併微量白蛋白尿及夜尿增多患者,進入研究前已接受氯沙坦鉀治療12週以上,按隨機數字錶法分為治療組和對照組,每組30例.治療組和對照組原有降壓藥物均繼續服用,治療組給予前列腺素E1治療3箇療程,同時常規使用氯沙坦鉀及其他降壓藥物,採用自身治療前後對比及與對照組對比,觀察患者前列腺素E1治療前後尿微量白蛋白(mALB)、尿滲透濃度、尿β2微毬蛋白(β2-MG)及尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)的變化情況.結果 兩組治療後血壓均下降,但與治療前比較差異無統計學意義(P＞0.05).治療組治療後12週尿mALB、尿β2-MG及尿NAG均低于對照組[(88.6±14.2)μg/min比(123.9± 14.8) μg/min、(0.84±0.41)mg/L比(1.61±0.49) mg/L、(30.2±10.5) U/L比(75.7±12.8) U/L],尿滲透濃度高于對照組[(591±71) mmol/L比(454±67) mmol/L],差異均有統計學意義(P＜0.01).結論 前列腺素E1可減輕早期高血壓腎髒損害患者腎髒缺血狀態,改善腎髒功能.
목적 관찰정맥주사전렬선소E1대고혈압합병미량백단백뇨환자신소구급신소관공능적개선작용.방법 선취60례고혈압합병미량백단백뇨급야뇨증다환자,진입연구전이접수록사탄갑치료12주이상,안수궤수자표법분위치료조화대조조,매조30례.치료조화대조조원유강압약물균계속복용,치료조급여전렬선소E1치료3개료정,동시상규사용록사탄갑급기타강압약물,채용자신치료전후대비급여대조조대비,관찰환자전렬선소E1치료전후뇨미량백단백(mALB)、뇨삼투농도、뇨β2미구단백(β2-MG)급뇨N-을선-β-D-안기포도당감매(NAG)적변화정황.결과 량조치료후혈압균하강,단여치료전비교차이무통계학의의(P＞0.05).치료조치료후12주뇨mALB、뇨β2-MG급뇨NAG균저우대조조[(88.6±14.2)μg/min비(123.9± 14.8) μg/min、(0.84±0.41)mg/L비(1.61±0.49) mg/L、(30.2±10.5) U/L비(75.7±12.8) U/L],뇨삼투농도고우대조조[(591±71) mmol/L비(454±67) mmol/L],차이균유통계학의의(P＜0.01).결론 전렬선소E1가감경조기고혈압신장손해환자신장결혈상태,개선신장공능.
Objective To observe the effect ofprostaglandin E1 intravenously in the improvement of the function of renal glomeruli and renal tubules in hypertensive patients complicated with microalbuminuria.Methods Totally 60 hypertensive patients complicated with microalbuminuria and nocturia who had received losartan for above 12 weeks,according to random number table method were divided into treatment group and control group,with 30 cases in each group.Original antihypertensive drugs were used continuously in treatment group and control group,and patients in treatment group received prostaglandin E1 intravenously for 3 courses of treatment,with losartan and other antihypertensive drugs routinely.Using self-contrast before and after treatment and contrast with control group,the change of urinary level of microalbumin (mALB),osmotic pressure,β2-microglodulin (β 2-MG) and N-acetyl-β-D-glucosaminidase (NAG) were compared.Results The blood pressure after treatment in both groups were decreased,but there was no statistically significant difference compared with that before treatment (P ＞ 0.05).After treatment of 12 weeks,urinary levels of mALB,β 2-MG and NAG in treatment group were lower than those in control group [(88.6 ± 14.2)μg/min vs.(123.9 ± 14.8) μg/min,(0.84 ±0.41) mg/L vs.(1.61 ±0.49) mg/L,(30.2 ± 10.5) U/L vs.(75.7 ± 12.8) U/L],and osmotic pressure was higher than that in control group [(591 ± 71) mmol/L vs.(454 ± 67) mmol/L],the difference had statistical significance (P ＜ 0.01).Conclusion Prostaglandin E1can reduce the renal ischemic state in early stage of hypertensive renal damage and can improve renal function.
