前列地尔联合依那普利对早期糖尿病肾病患者血清超敏C-反应蛋白及胱抑素的研究  

Effects of Alprostadil combined with Enalapril on high sensitivity C-reactive protein and cystatin in patients with early diabetic nephropathy

作　　者：王彦敏[1] 孙志芬 邵鹏[1] 邢喜芝 李朋霞 刘金鹏 王海涛 

机构地区：[1]河北省沧州中西医结合医院,061000 [2]沧州市和平医院

出　　处：《中国综合临床》2011年第10期1062-1065,共4页Clinical Medicine of China

摘　　要：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（Cyst）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100ml，静脉滴注，1次／a；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100ml，静脉滴注，1次／d，联合依那普利5mg，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（24hUAE）、Hs-CRP及CysC的变化。结果治疗后3组中hs-CRP、CysC及24hUAE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]、24hUAE[（242．19±24．68）mg／24h与（256．32±32．40）rag／24h，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]、24hUAE[（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]、24hUAE[（218．764-22．10）mg／24h与（251．56±34．16）mg／24h，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／I．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]、24hUAE[（218．76±22．10）rag／24h与（242．19±24．68）rag／24h，t=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（7．8Objective 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 10μg ＋ 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 p,g ＋ 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 （HbAtc） ,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 nephropathy and can reduce the levels of CysC and hs-CRP.

关 键 词：糖尿病肾病 超敏C反应蛋白 胱抑素 依那普利 前列地尔 

分 类 号：R587.2[医药卫生—内分泌]