常规治疗联合丹参多酚酸盐、前列地尔、谷胱甘肽延缓糖尿病肾病患者肾功能减退的临床研究  

Preventive Effects of Salvianolate Combined with Alprostadil and Glutathione on Progression of Renal Failure in Patients with Diabetic Nephropathy

作　　者：查芳芳[1] 朱迎春[1] 吴莲叶[1] 王青[1] 杜红秀[1] 白寿军[1] 

机构地区：[1]复旦大学附属中山医院青浦分院肾内科,上海201700

出　　处：《中国临床医学》2013年第3期330-332,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨常规治疗联合丹参多酚酸盐、前列地尔、谷胱甘肽延缓糖尿病肾病(diabetic nephropathy,DN)患者肾功能减退的疗效。方法:选取复旦大学附属中山医院青浦分院肾内科2009年12月—2012年12月住院治疗的40例DN患者,随机分为联合治疗组(21例)和对照组(19例)。在常规治疗基础上,联合治疗组给予静脉滴注丹参多酚酸盐、前列地尔和谷胱甘肽,疗程7～14 d,每两个月一次;对照组进行常规治疗,观察治疗前后患者的血常规、血糖、血红蛋白(Hb)、糖化血红蛋白(HbA1c)、电解质、血清白蛋白、肝功能、尿蛋白/肌酐比值(ACR)及血肌酐的变化,计算估测的肾小球滤过率(eGFR)。研究终点为eGFR较基础水平下降50%或进入替代治疗阶段,随访时间平均3年。结果:接受治疗3年后,两组患者Hb、血糖、HbA1c及电解质水平无明显变化(P>0.05);与对照组比较,联合治疗组患者血清白蛋白和eGFR明显增高(P<0.05);ACR和血肌酐明显下降(P<0.05);联合治疗组进入研究终点的患者比例(47%,10/21)显著低于对照组(78%,15/19),P<0.05。结论:长时间应用丹参多酚酸盐、前列地尔、还原型谷胱甘肽的联合疗法可延缓DN患者的肾功能恶化。Objective：To investigate the preventive effects of salvianolate combined with alprostadil and glutathione on progression of renal failure in patients with diabetic nephropathy（DN）.Methods：Forty patients suffered from DN were randomly assigned to study group（21 cases） and control group（21 cases）.Patients in the control group only received conventional therapy Besides conventional treatment,patients in the treatment group were also treated with salvianolate,alprostadil and glutathione for 10 to 14 days in every 2 months.Blood routine examination,blood glucose,hemoglobin（Hb）,hemoglobin A1c（HbA1c）,electrolyte,serum albumin,liver function,albumin to creatinine ratio（ACR）,serum creatinine and estimated glomerular filtration rate（eGFR） were observed in patients before and after treatment.The study termination was set as eGFR decreased by 50% compared with the basic level or the begining of replacement therapy,and the average follow-up time was 3 years.Results： After treatment for 3 years,no significant changes were found in the levels of serum Hb,blood glucose,HbA1c and electrolyte between the two groups（P0.05）.Compared with the control group,the serum albumin level and eGFR in the treatment group were significantly elevated（P0.05）,while ACR and serum creatitine were significantly decreased（P0.05）.The percentage of patients reaching the study termination in the treatment group（47%） was significantly smaller compared with that in the control group（78%）,（P0.05）.Conclusions： Long time use of salvianolate,alprostadil and glutathione may effectively delay the deterioration of renal function in patients with DN.

关 键 词：糖尿病肾病 丹参多酚酸盐 前列地尔 还原型谷胱甘肽 肾功能 

分 类 号：R692[医药卫生—泌尿科学]