依帕司他联合前列地尔对老年糖尿病肾病患者肾功能、微炎症状态及肾叶间质动脉血流动力学参数的影响  

To Investigate the Effects of Epalrestat Combined with Alprostadil on Renal Function,Microinflammatory State and Renal Interstitial Artery Hemodynamic Parameters in Elderly Patients with Diabetic Nephropathy

作　　者：岳继鹏 许兰亭 李冰 YUE Jipeng;XU Lanting;LI Bing(Department of Internal Medicine,Jigang Hospital,Jiyuan,Henan 459000,China)

机构地区：[1]济钢医院内科,河南济源459000

出　　处：《生物医学工程学进展》2025年第1期91-96,共6页Progress in Biomedical Engineering

摘　　要：目的探索依帕司他联合前列地尔在老年糖尿病肾病患者中的应用效果。方法选取河南济源济钢医院2021年7月至2023年7月收治的97例老年糖尿病肾病患者作为研究对象,采用抽签法将患者分为前列腺素类药物组和醛糖还原酶抑制组。前列腺素类药物组48例给予前列地尔治疗,醛糖还原酶抑制组49例给予依帕司他联合前列地尔治疗。3个月后,对比两组肾功能、微炎症状态、肾叶间质动脉血流动力学参数、不良反应。结果两组治疗3个月后,血肌酐(Scr)、血清尿素氮(BUN)水平较治疗前降低,醛糖还原酶抑制组低于前列腺素类药物组(P<0.05)。两组治疗3个月后,超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平较治疗前升高,醛糖还原酶抑制组高于前列腺素类药物组;丙二醛(MDA)水平较治疗前降低,醛糖还原酶抑制组低于前列腺素类药物组(P<0.05)。两组治疗3个月后,收缩期峰值血流速度Vmax、舒张末期血流速度Vmin水平较治疗前升高,醛糖还原酶抑制组高于前列腺素类药物组;双侧肾叶间质阻力指数(RI)水平较治疗前降低,醛糖还原酶抑制组低于前列腺素类药物组(P<0.05)。经Fisher确切概率法检验,醛糖还原酶抑制组不良反应发生率为8.16%(4/49),与前列腺素类药物组的4.17%(2/48)比较无差异(P>0.05)。结论依帕司他联合前列地尔可调节老年糖尿病肾病患者肾叶间质动脉血流动力学参数,改善肾功能,调节微炎症状态,安全性良好。Objective To explore the effect of epalrestat combined with alprostadil in the treatment of elderly patients with diabetic nephropathy.Methods A total of 97 elderly patients with diabetic nephropathy in Jigang Hospital of Jiyuan,Henan Province from July 2021 to July 2023 were selected as the research objects.The patients were divided into a prostaglandin group and a aldose reductase inhibition group by a lottery method.Forty-eight patients in the prostaglandin group were treated with alprostadil,and 49 patients in the aldose reductase inhibition group were treated with epalrestat combined with alprostadil.After 3 months,the renal function,microinflammatory state,renal interstitial artery hemodynamic parameters,and adverse reactions were compared between the two groups.Results After 3 months of treatment,the levels of serum creatinine(Scr)and bloud urea nitrogen(BUN)levels decreased compared to pre-treatment levels in both groups,and those in the aldose reductase inhibition group were lower than those in the prostaglandin group(P<0.05).After 3 months of treatment,the superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)levels in both groups increased compared to those before treatment,with the aldose reductase inhibition group showing higher levels than the prostaglandin group.The malondiald-ehyde(MDA)level decreased in both groups compared to that before treatment,and that in the aldose reductase inhibition group was lower than that in the prostaglandin group(P<0.05).After 3 months of treatment,the peak systolicflow velocity Vmax and end-diastolic flow velocity Vmin levels of the two groups increased compared to those before treatment,and the aldose reductase inhibition group showed higher levels than the prostaglandin group.The level of resistance index(RI)decreased in both groups compared to that before treatment,with that in the aldose reductase inhibition group lower than that in the prostaglandin group(P<0.05).There was no significant difference in the incidence of adverse reactions between the aldose

关 键 词：依帕司他 前列地尔 糖尿病肾病 肾功能 

分 类 号：R587.2[医药卫生—内分泌]