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目的:探讨前列地尔联合缬沙坦对糖尿病肾病患者尿蛋白排泄率(UAER)以及血肌酐水平的影响。方法:选取2013年1月-2016年4月我院收治的糖尿病肾病患者86例,随机分成前列地尔组、缬沙坦组及联合组三组。前列地尔组患者在常规治疗基础上采用前列地尔静滴治疗,治疗周期2周;缬沙坦组患者在常规治疗基础上采用缬沙坦口服治疗,治疗周期2周;联合组患者在常规治疗基础上采用前列地尔静滴联合缬沙坦口服治疗,治疗周期2周。检测分析所有患者治疗前后24小时尿蛋白排泄率以及血肌酐水平变化情况。结果:尿蛋白排泄率指标上,治疗前三组患者间不存在显著差异(P>0.05);三组患者经过不同手段治疗后均显著低于治疗前(P<0.05);治疗后,前列地尔组与缬沙坦组间不存在差异,联合组显著低于前列地尔组及缬沙坦组(P<0.05)。血肌酐水平指标上,治疗前三组患者间不存在显著差异(P>0.05);经过不同手段治疗后,三组患者与治疗前均存在显著差异(P<0.05);前列地尔组与缬沙坦组间不存在显著差异(P>0.05);联合组与前列地尔组及缬沙坦组间均存在显著差异,差异有统计学意义(P<0.05)。结论:前列地尔联合缬沙坦治疗糖尿病肾病,可有效改善肾小球血液循环,降低尿蛋白的排泄,保护肾功能,疗效确切,值得临床应用推广。
Objective: To investigate the effects of alprostadil combined with valsartan on urinary protein excretion rate (UAER) and serum creatinine in patients with diabetic nephropathy. Methods: From January 2013 to April 2016, 86 patients with diabetic nephropathy admitted to our hospital were randomly divided into three groups: alprostadil group, valsartan group and combination group. Patients in the alprostadil group were treated with alprostadil for 2 weeks on the basis of routine treatment. Patients in the valsartan group were treated with valsartan orally on the basis of routine treatment for 2 weeks. Patients in the combined group were treated with conventional Treatment based on the use of alprostadil combined with valsartan oral treatment, the treatment cycle of 2 weeks. All patients were tested before and after treatment of urinary protein excretion rate and serum creatinine levels. Results: Urine protein excretion rate indicators, there was no significant difference between the three groups before treatment (P> 0.05); after treatment by three different methods, the three groups of patients were significantly lower than before treatment (P <0.05); after treatment, There was no difference between the valsartan group and the valsartan group. The combined group was significantly lower than the alprostadil group and the valsartan group (P <0.05). Serum creatinine level indicators, there was no significant difference between the three groups before treatment (P> 0.05); after treatment by different means, there were significant differences between the three groups before treatment (P <0.05) There was no significant difference between the two groups (P> 0.05). There were significant differences between the combination group and the alprostadil group and the valsartan group (P <0.05). Conclusion: Alprostadil combined with valsartan in the treatment of diabetic nephropathy can effectively improve glomerular blood circulation, reduce urinary protein excretion and protect renal function with definite curative effect, which is worthy of clinical application.