左卡尼汀联合前列地尔治疗糖尿病肾病的疗效及其对患者血清Cys C及RBP水平的影响  

Clinical efficacy of levocarnitine combined with alprostadil in the treatment of diabetic nephropathy and the influence on serum Cys C and retinol binding protein levels

作　　者：黄娟[1] 胡维[1] 熊丹[1] 

机构地区：[1]湖南中医药大学第一附属医院内分泌科,湖南长沙410007

出　　处：《海南医学》2018年第2期183-186,共4页Hainan Medical Journal

摘　　要：目的探讨左卡尼汀联合前列地尔治疗糖尿病肾病(DN)的疗效及其对患者血清半胱氨酸蛋白酶抑制剂C(Cys C)及视黄醇结合蛋白(RBP)水平的影响。方法将2014年4月至2017年4月期间入住湖南中医药大学第一附属医院内分泌科的150例DN患者按照随机数表法分为对照组(n=74)与观察组(n=76),两组均根据患者发病情况首先给予基础治疗,对照组在此基础上联合前列地尔治疗,观察组在对照组基础上联合左卡尼汀治疗,疗程均为4周。比较两组患者的临床疗效及治疗前后的血清Cys C及RBP水平,采用SF-12生活质量量表评价两组患者治疗前后的生活质量。结果 (1)观察组患者的临床治疗总有效率为93.42%,明显高于对照组的70.27%,差异有统计学意义(P<0.05);(2)对照组患者治疗前后的Cys C水平分别为(2.98±0.56)mg/L、(1.59±0.44)mg/L,观察组分别为(3.02±0.61)mg/L、(0.88±0.16)mg/L;对照组治疗前后的RBP水平分别为(102.25±22.31)mg/L、(69.68±5.67)mg/L,观察组分别为(100.02±21.18)mg/L、(49.35±4.33)mg/L,两组患者治疗后血清Cys C及RBP水平均明显低于治疗前,且观察组患者治疗后血清Cys C及RBP水平也均明显低于对照组,差异均有统计学意义(P<0.05);(3)观察组患者治疗后的生活质量量表相关维度(总体健康、情感职能、躯体疼痛及精神健康)评分均明显高于对照组,差异均有统计学意义(P<0.05);(4)观察组患者的不良反应总发生率为6.58%,明显低于对照组的17.57%,差异有统计学意义(P<0.05)。结论左卡尼汀联合前列地尔治疗DN可有效降低患者血清Cys C与RBP水平,疗效显著,安全性高,值得临床中推广应用。Objective To investigate the clinical efficacy of levocarnitine combined with alprostadil in the treatment of diabetic nephropathy（DN） and its effect on serum cysteine inhibitor C（Cys C） and retinol binding protein（RBP） in patients. Methods A total of 150 patients with DN in the Department of Endocrinology, the First Hospital of Hunan University of Chinese Medicine from April 2014 to April 2017 were enrolled. The patients were divided into control group（n=74） and observation group（n=76） according to random number method. Based on basic treatment, the control group was given alprostadil, and observation group received levocarnitine combined with alprostadil for treatment,both for 4 weeks. The clinical efficacy, serum Cys C and RBP levels before and after treatment were compared between the two groups. The quality of life before and after treatment was evaluated by SF-12. Results（1） The total effective rate was 93.42% in the observation group, which was significantly higher than 70.27% in the control group（P0.05）.（2） The levels of Cys C before and after treatment were（2.98±0.56） mg/L,（1.59±0.44） mg/L in the control group, and（3.02±0.61） mg/L,（0.88 ± 0.16） mg/L in the observation group. The levels of RBP before and after treatment were（102.25 ±22.31） mg/L,（69.68±5.67） mg/L in the control group and（100.02±21.18） mg/L,（49.35±4.33） mg/L in the observation group. The serum Cys C and RBP levels after treatment in the two groups were significantly lower than those before treatment, and the levels after treatment in the observation group were significantly lower than those in the control group（P0.05）.（3） The quality of life scores（overall health, emotional function, somatic pain and mental health） in the observation group after treatment were significantly higher than those in the control group（P0.05）.（4） The total incidence of adverse events in the observation group was significantly lower than that of the control group（6.58% vs

关 键 词：糖尿病肾病 前列地尔 左卡尼汀 半胱氨酸蛋白酶抑制剂C 视黄醇结合蛋白 生活质量 

分 类 号：R587.2[医药卫生—内分泌]