前列地尔对Ⅲ期糖尿病肾病患者尿蛋白影响.docVIP

前列地尔对Ⅲ期糖尿病肾病患者尿蛋白影响 　　[摘要]目的 观察前列地尔对Ⅲ期糖尿病肾病（DN）患者尿蛋白的影响。方法 选取2014年8月～2016年7月在益都中心医院住院治疗的Ⅲ期DN患者60例，将其随机分为观察组和对照组，各30例。所有患者在均给予常规治疗1个月，观察组在常规治疗基础上给予前列地尔（10 μg/d）治疗2周，对照组继续给予常规治疗。治疗前后分别进行尿白蛋白肌酐比值（Alb/Cr）、β2-MG肌酐比值（β2-MG/Cr）、免疫球蛋白G肌酐比值（IgG/Cr）测定，比较治疗前后的上述指标。结果 观察组治疗后的尿Alb/Cr、β2-MG/Cr较治疗前降低（P0.05）；治疗后，观察组较对照组的尿Alb/Cr、β2-MG/Cr降低（P0.05）。结论 前列地尔可减少Ⅲ期 DN患者尿蛋白排泄，其机制可能与肾小球基底膜电荷屏障的修复有关，同时对损伤肾小管也有保护作用，但对肾小球基底膜的结构损伤无修复作用。 　　[关键词]前列地尔；糖尿病肾病；尿蛋白 　　[中图分类号] R587.2 [文献标识码] A [文章编号] 1674-4721（2017）09（b）-0045-03 　　Influence of Alprostadil on urinary protein in patients with diabetic nephropathy of stage Ⅲ 　　DING Hui1 GUO Xiao-lin1 GUO Shi-biao2 　　1.Weifang Medical University in Shandong Province，Weifang 261053；2.Department of Endocrine，Yidu Central Hospital in Shandong Province，Qingzhou 262500，China 　　[Abstract]Objective To observe the influence of Alprostadil on urinary protein in patients with diabetic nephropathy of stage Ⅲ.Methods 60 patients with diabetic nephropathy of stage Ⅲ treated in Yidu Central Hospital from August 2014 to July 2016 were selected and randomly divided into the observation （n=30） and the control group（n=30）.All patients were given the routine treatment for 1 month，the observation group was treated with Alprostadil （10 μg/d） for 2 weeks，while the control group was given the routine treatment continuously.The determination of urinary albumin to creatinine ratio （Alb/Cr），the urinary β2-micro globulin to creatinine ratio （β2-MG/Cr） and immunoglobulin G to creatinine ratio （IgG/Cr） before and after treatment were conducted.Results After treatment，Alb/Cr and β2-MG/Cr were decreased compared with before treatment （P0.05）in the observation group.Compared with the control group，Alb/Cr and β2-MG/Cr were decreased （P0.05）in the observation group after treatment.Conclusion Alprostadil can reduce the urinary protein excretion in patients with diabetic nephropathy of stage Ⅲ，the mechanism may be related to the repair of glomerular basement membrane charge barrier，an