前列地尔治疗Ⅰ-Ⅱ期特发性膜性肾病的临床与血液流变学研究  

Study on clinical and hemorrheology of alprostadil injection in the treatment of Ⅰ-Ⅱ stage idiopathic membranous nephropathy

作　　者：骆青[1] 刘笑南[1] 孔刚[1] 

机构地区：[1]泰山医学院附属泰山医院,山东泰安271000

出　　处：《泰山医学院学报》2015年第2期156-158,共3页Journal of Taishan Medical College

摘　　要：目的观察前列地尔对I-II期特发性膜性肾病的临床与血流变学的作用。方法将36例经肾脏活检诊断为I-II期特发性膜性肾病患者随机平均分为两组,即对照组和治疗组,每组18例。两组均常规均给予泼尼松联合环磷酰胺治疗。治疗组在此基础上加用前列地尔治疗。治疗前后检测24 h尿蛋白定量、血浆白蛋白、血肌酐、内生肌酐清除率以及血液流变学指标结果。结果对照组和治疗组在治疗后2 4h尿蛋白定量明显下降,血浆白蛋白显著提高,有统计学意义(P<0.05)。血肌酐、内生肌酐清除率无明显变化,无统计学意义(P>0.05)。而治疗后,治疗组的24 h尿蛋白定量以及血浆白蛋白改善明显优于对照组,有统计学意义(P<0.05)。对照组患者全血黏度(低切、高切)、血浆黏度、纤维蛋白原等血液流变学指标与治疗前比较差异无显著性(P>0.05),而治疗组患者血液流变学指标较治疗前有明显改善(P<0.05),同时治疗组与对照组患者治疗后血液流变学指标比较差异有显著性(P<0.05)。结论前列地尔不仅能降低I-II期特发性膜性肾病患者尿蛋白含量,提升血浆白蛋白水平,而且能改善血流微循环,减少血栓形成的可能,从而能有效延缓肾脏疾病的进展。Objective：To observe clinical and blood rheology effect of alprostadil to I - II stage idiopathic membranous nephropathy. Method：36 cases of renal biopsy for the diagnosis of I - II in patients with idiopathic membranous nephropa-thy were randomly divided into two groups,The control group and treatment group,each group consists of 18 cases. The two groups were both given prednisone and cyclophosphamide treatment,the treatment group was combined with alprostadil on the basis of routine treatment. Before and after treatment,24h urinary protein,plasma albumin,serum creatinine,cre-atinine clearance rate and the indexes of blood rheology were observed. Result：After treatment of the control group and the treatment group,24h urinary protein decreased significantly,and plasma albumin was significantly increased,there was sta-tistical significance（P 0. 05）. After treatment,the 24 h urine protein quantitative,and plasma albumin of the treat-ment group were significantly better than the control group,there was statistical significance（P 0. 05）,While the blood rheology of the treatment group im-proved significantly compared with before treatment（P 〈 0. 05）. At the same time,the blood rheology of the treatment group had significant difference compared with the control group of patients after treatment（P 〈 0. 05）. Conclusion：Alpros-tadil can not only reduce proteinuria in patients with stage I - II idiopathic membranous nephropathy ,increase the plasma albumin level,but also improve the blood microcirculation,reduce the possibility of thrombosis,which can effectively delay the progression of renal disease.

关 键 词：前列地尔 膜性肾病 尿蛋白定量 血浆白蛋白 血流变 

分 类 号：R692.3[医药卫生—泌尿科学]