前列地尔联合左卡尼汀对终末期糖尿病肾病患者血清Toll样受体-4、视黄醇结合蛋白及前白蛋白的影响  

Effect of Alprostadil Combined with Levocarnitine on Serum Toll-like Receptor-4,Retinol Binding Protein and Prealbumin of Patients with End-Stage Diabetic Nephropathy

作　　者：刘丹 郝伟迤 苏强 文婧 罗晓波 LIU Dan;HAO Wei-yi;SU Qiang;WEN Jing;LUO Xiao-bo(Nanchong Central Hospital,Nanchong,Sichuan 637000,China)

机构地区：[1]南充市中心医院药剂科,四川南充637000

出　　处：《解放军医药杂志》2021年第2期47-50,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：四川省卫生和计划生育委员会科研课题普及应用项目(16pj211)。

摘　　要：目的分析前列地尔联合左卡尼汀对终末期糖尿病肾病(ESDN)血清Toll样受体-4(TLR-4)、视黄醇结合蛋白(RBP)及前白蛋白(PA)的影响。方法回顾分析2017年1月—2019年10月我院收治的ESDN患者96例的临床资料,根据治疗方式不同分为对照组41例和观察组55例。对照组给予前列地尔,观察组在对照组基础上加用左卡尼汀。比较2组临床疗效,治疗前后TLR-4、RBP、PA表达、肾功能及不良反应情况。结果观察组临床总有效率高于对照组(P<0.05)。与治疗前相比,2组治疗后TLR-4、RBP水平减低、PA水平升高,且观察组较对照组变化更显著(P<0.05)。2组治疗后血肌酐(SCr)、尿素(BUN)水平均减低,且观察组低于对照组(P<0.05),但2组GFR治疗前后组间及组内比较差异无统计学意义(P>0.05)。2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论前列地尔联合左卡尼汀可降低TLR-4、RBP表达水平,调高PA表达,从而改善患者体内微炎性环境,保护肾功能,临床疗效佳。Objective To analyze the effect of Alprostadil combined with Levocarnitine on serum Toll-like receptor-4(TLR-4),retinol binding protein(RBP)and prealbumin(PA)of patients with end stage diabetic nephropathy(ESDN).Methods The clinical data of 96 ESDN patients admitted to our hospital from January 2017 to October 2019 were retrospectively analyzed.According to different treatment methods,they were divided into control group(n=41)and observation group(n=55).The control group was given Alprostadil,and the observation group was supplemented with Levocarnitine on the basis of the control group.The clinical efficacy,expression of TLR-4,RBP and PA,renal function and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).Compared with those before treatment,TLR-4 and RBP levels were decreased and PA levels were increased in both groups after treatment;the changes in the observation group were more significant than those in the control group(P<0.05).After treatment,the levels of serum creatinine(SCr)andurea nitrogen(BUN)in the two groups were decreased,and the levels were lower in the observation group than in the control group(P<0.05),but there was no significant intra-and inter-difference before and after GFR treatment(P>0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Alprostadil combined with Levocarnitine can reduce the expression levels of TLR-4 and RBP,and increase the expression level of PA,thereby improving the micro-inflammatory environment in patients,and protecting renal function.Therefore,it has good therapeutic effects in clinical practice.

关 键 词：糖尿病肾病 前列地尔 左卡尼汀 血清Toll样受体-4 视黄醇结合蛋白质类 前白蛋白 肾小球滤过率 尿素 

分 类 号：R587.1[医药卫生—内分泌]