贝前列素钠、前列地尔联合α酮酸治疗慢性肾脏病老年患者的临床研究  

Clinical Researchon the Treatment of Elderly Patients with Chronic Kidney Disease with Prostaglandin Sodium,Alprostadil and α-ketoacid

作　　者：武君 WU Jun(Department of Nephrology,the Third Hospital ofNanchang City,Nanchang Jiangxi 330009,China)

机构地区：[1]南昌市第三医院肾内科,江西南昌330009

出　　处：《药品评价》2020年第11期59-61,64,共4页Drug Evaluation

摘　　要：目的:评价贝前列素钠、前列地尔联合α酮酸治疗慢性肾脏疾病(CKD)老年患者的疗效与安全性。方法:选取2018年5月至2020年4月在我院肾内科治疗的117例老年CKD患者。根据随机数字表法将患者随机分为3组,即联合治疗组(联合组,n=39)、α酮酸组(n=39)与对照组(n=39)。对照组患者给予常规CKD方案治疗,α酮酸组在对照组治疗的基础上服用α酮酸治疗,联合组在α酮酸组治疗的基础上加用前列地尔注射液静脉滴注+口服前列素钠片序贯治疗。治疗前后检测并比较3组患者的血尿素氮(BUN)、肾小球滤过率估算值(eGFR)、血清肌酐(SCr)、胱抑素C(CysC),比较3组患者D-二聚体、血小板计数(PLT)、纤维蛋白原与凝血酶原时间(PT)及不良反应发生率。结果:治疗后,联合组BUN、CysC、SCr均较治疗前明显降低,eGFR较治疗前明显提高(均P<0.05)。联合组BUN、CysC、SCr均较对照组明显降低,eGFR较对照组明显提高(均P<0.05)。联合组BUN、CysC、SCr均较α酮酸组明显降低,eGFR较α酮酸组明显提高(均P<0.05)。治疗后,联合组D-二聚体、纤维蛋白原较治疗前明显降低,也较对照组显著降低(均P<0.05)。联合组、α酮酸组与对照组患者不良反应发生率差异无统计学意义[5.13%(2/39) vs.2.56%(1/39) vs.0.00%(0),χ^2=2.073,P=0.355]。结论:贝前列素钠、前列地尔联合复方α酮酸治疗能够有效延缓老年CKD患者疾病进展,安全性好、疗效高。Objective:To evaluate the efficacy and safety of prostaglandin sodium,alprostadil andα-ketoacid in the treatment of elderly patients with chronic kidney disease(CKD).Methods:From May 2018 to April 2020,117 elderly CKD patients who were treated in the Department of Nephrology of our hospital were selected.According to the method of random number table,the patients were randomly divided into three groups:the combined treatment group(n=39),theα-ketoacid group(n=39)and the control group(n=39).The patients in the control group were treated with conventional CKD regimen.The patients in theα-ketoacid group were treated withα-ketoacid on the basis of the treatment in the control group.The patients in the combined group were treated with alprostadil injection plus oral prostaglandin sodium tablets.Blood urea nitrogen(BUN),estimated glomerular filtration rate(eGFR),serum creatinine(SCr),Cystatin C(CysC)were measured and compared before and after treatment.D-dimer,platelet count(PLT),fibrinogen and prothrombin time(PT)and adverse reactions were compared among the three groups.Result:Safter treatment,Bun,CysC and SCr in the combined group were significantly lower than before treatment,and eGFR was significantly higher than before treatment(P<0.05).Bun,CysC and SCR in the combined group were significantly lower than those in the control group,and eGFR was significantly higher than that in the control group(all P<0.05).In the combined group,Bun,CysC and SCr were significantly lower than those in theα-ketoacid group,and eGFR was significantly higher than those in theα-ketoacid group(P<0.05).After treatment,D-dimer and fibrinogen in the combined group were significantly lower than those before treatment,and also significantly lower than those in the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the combined group and theα-ketoacid group compared with the control group[5.13%(2/39)vs.2.56%(1/39)vs.0.00%(0),χ^2=2.073,P=0.355].Conclusion:The treatment of prostagla

关 键 词：贝前列素钠 前列地尔 α酮酸治疗 慢性肾脏病 

分 类 号：R692.5[医药卫生—泌尿科学]