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100例2型糖尿病早期肾病患者,随机分为治疗组和对照组,各50例。两组患者均在糖尿病饮食、运动、摄入低蛋白饮食、待血糖血压稳定后。治疗组予以骨化三醇25μg/次1次/日口服,前列地尔10μg加入100ml生理盐水静脉注射,1次/日,连续治疗14天。对照组予以前列地尔10μg加入100ml生理盐水静脉滴注,1次/日,连续治疗14天。检测两组患者治疗前后尿β2微球蛋白(β2-MG)、尿微量蛋白排泄率(UAER)、血清肌酐清除率(Ccr)、血清尿素氮(BUN)、高敏C反应蛋白(hs-CRP)水平的变化。结果治疗组β2MG为(0.77±1.25)mg/L,UAER为(117.75±35.43)mg/24h,hs-CRP为(0.19±0.21)mg/dL,与治疗前β2MG(9.11±10.85)mg/L,UAER(155.00±15.41)mg/24h,hs-CRP(0.27±0.22)mg/dL,及对照组治疗后的β2MG(6.10±4.13)mg/L,UAER(140.20±26.02)mg/24h,hs-CRP(0.26±0.09)mg/dL相比均有明显下降,P<0.05。而两组BUN、Ccr治疗前后均无统计学差异(P>0.05)。结论骨化三醇与前列地尔联合用药可明显减轻2型糖尿病早期肾病患者尿蛋白、高敏C反应蛋白状态。其机制可能与骨化三醇、前列地尔均有抑制肾脏RAS活性及免疫反应有关。
100 cases of type 2 diabetic patients with early nephropathy were randomly divided into treatment group and control group, 50 cases each. Two groups of patients in the diabetic diet, exercise, intake of low-protein diet, to be stable blood sugar and blood pressure. The treatment group was calcitriol 25μg / time 1 / day orally, alprostadil 10μg intravenous injection of 100ml saline, 1 times / day, continuous treatment for 14 days. The control group was given alprostadil 10μg intravenous infusion of 100ml saline, 1 times / day, continuous treatment for 14 days. The levels of urinary β2-MG, UAER, Ccr, BUN and hs-CRP in the two groups were measured before and after treatment. Horizontal changes. Results The β2MG of the treatment group was (0.77 ± 1.25) mg / L, the UAER was (117.75 ± 35.43) mg / 24h and the hs-CRP was 0.19 ± 0.21 mg / dL , UAER (155.00 ± 15.41) mg / 24h and hs-CRP (0.27 ± 0.22) mg / dL respectively, and the control group was 6. 2 ± 4.13 mg / L and 140.20 ± 26.02 mg / -CRP (0.26 ± 0.09) mg / dL, P <0.05. There was no significant difference between the two groups before and after treatment of BUN and Ccr (P> 0.05). Conclusions The combination of calcitriol and alprostadil can significantly reduce urinary protein and high-sensitivity C-reactive protein in type 2 diabetic patients with early nephropathy. The mechanism may be associated with calcitriol, prostaglandin inhibition of renal RAS activity and immune response.