前列地尔剂量差异对糖尿病肾病患者肾功能、炎性细胞因子及氧化应激水平的影响  

Effect of different doses of alprostadil on renal function, inflammatory cytokines and oxidative stress in patients with diabetic nephropathy

作　　者：杨平安[1] 

机构地区：[1]山西省人民医院内分泌科,太原030012

出　　处：《中国实用医刊》2017年第23期96-99,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨前列地尔剂量差异对糖尿病肾病（DN）患者肾功能、炎性细胞因子及氧化应激水平的影响。方法选取确诊的DN患者108例，依据前列地尔使用剂量分为观察组（n=54）和对照组（／1=54）。观察组给予大剂量（20μg／d）前列地尔注射液治疗，对照组给予常规剂量（10μg／d）前列地尔注射液治疗，两组均连续治疗2周。检测并比较两组患者肾功能、炎性细胞因子及氧化应激水平变化，统计两组不良反应发生情况。结果治疗后两组血肌酐（Scr）、血尿素氮（BUN）、尿白蛋白排泄率（UAER）、尿β2-微球蛋白（Uβ2-MG）及尿α1-微球蛋白（Uα1-MG）水平均明显下降（P〈0．05或P〈0．01），且观察组较对照组下降更为显著（P〈0．01）。治疗后两组白细胞介素-8（IL-8）及肿瘤坏死因子-α（TNF-α）水平均下降，白细胞介素-4（IL-4）水平明显升高（P〈0．01），且两组间比较差异有统计学意义（P〈0．01）。治疗后两组血浆丙二醛（MDA）及活性氧（ROS）水平下降，超氧化物歧化酶（SOD）水平升高（P〈0．01），且两组间比较差异有统计学意义（P〈0．01）。两组间不良反应发生率比较差异未见统计学意义（P〉0．05）。结论对DN患者实施大剂量前列地尔注射液治疗有助于改善其临床特征，减轻机体炎症反应和氧化应激反应，对肾功能的恢复效果确切。Objective To investigate the efficacy of different doses of alprostadil on renal function, inflammatory cytokines and oxidative stress in patients with diabetic nephropathy. Methods A total of 108 DN patients were collected and divided into observation group （n = 54） and control group （n =54） according to dosages of alprostadil. The patients in observation group were treated with large doses （20 μg/d） of alprostadil injection, patients in control group received conventional doses （10 I^g/d） of alprostadil injection. The two groups were treated continuously for 2 weeks. The renal function, inflam- matory cytokines and oxidative stress were detected and compared between the two groups. The adverse reactions of the two groups were statistically analyzed. Results After treatment, the levels of serm creat- inine （Scr）, blood urea nitrogen （BUN）, urinary albumin excretion rate （UAER）, Uβ-microglobnlin （Uβ2-MG） and Uαl-MG in two groups decreased （P 〈0. 05 or P 〈0.01 ）, and the indexes in observa- tion group was significantly lower than those in control group （P 〈0.01）. After treatment, the levels of interleukin-8 （IL-8） and tumor necrosis factor-α （TNF-α） in the two groups decreased, the level of IL-4 showed a markedly elevated state （P 〈 0. 01 ）, and the difference between the two groups was significant （P 〈 0.01 ）. After treatment, the levels of malondialdehyde and reactive oxygen species in the two groups decreased, and the level of superoxide dismustase showed an obvious elevated state （P 〈0. 01 ）, and the difference between the two groups was significant （P 〈 0.01 ）. The incidence of adverse reactions between the two groups was not statistically significant （P 〉 0. 05 ）. Conclusions High dose of alpros-tadil injection treatment for DN patients can be helpful to improve the clinical characteristics, reduce the inflammatory reaction and oxidative stress, and restore the renal function.

关 键 词：糖尿病肾病 前列地尔 剂量 肾脏功能 炎性细胞因子 氧化应激 疗效 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]