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目的观察左卡尼汀联合前列地尔治疗糖尿病肾病临床疗效及安全性。方法将68例糖尿病肾病患者随机分为对照组34例与试验组34例。对照组予以静脉滴注前列地尔1 m L,qd;试验组在对照组的基础上,联合静脉滴注左卡尼汀1 g,qd。2组患者均连续治疗28 d。比较2组患者的临床疗效、治疗前后的生化指标以及不良反应的发生情况。结果治疗后,对照组的总有效率为67.65%显著低于试验组的94.12%(P<0.05)。治疗后,2组患者的血清24 h尿蛋白定量、尿微球蛋白、尿素氮、胱抑素C、同型半胱氨酸、糖化血红蛋白、转化生长因子-β_1、Ⅳ型胶原水平均较治疗前显著降低,且试验组治疗后的上述指标均显著低于对照组(P<0.05)。治疗后,2组患者的血清肌酸酐、25-羟维生素D_3水平均较治疗前显著升高,且试验组治疗后的上述指标均显著高于对照组(P<0.05)。对照组不良反应发生率为23.53%显著高于试验组的8.82%(P<0.05)。结论左卡尼汀联合前列地尔治疗糖尿病肾病的临床疗效显著,且安全性较高。
Objective To observe the clinical efficacy and safety of levocarnitine and alprostadil in the treatment of diabetic nephropathy. Methods Sixty-eight patients with diabetic nephropathy were randomly divided into control group (34 cases) and experimental group (34 cases). The control group was given intravenous alprostadil 1 m L, qd; experimental group in the control group based on the combination of intravenous infusion of levocarnitine 1 g, qd. The patients in both groups were treated for 28 days continuously. The clinical efficacy, biochemical indexes before and after treatment and the incidence of adverse reactions were compared between the two groups. Results After treatment, the total effective rate of the control group was 67.65%, which was significantly lower than that of the experimental group (94.12%, P <0.05). After treatment, serum 24 h urinary protein, urinary microglobulin, urea nitrogen, cystatin C, homocysteine, glycosylated hemoglobin, transforming growth factor-β 1 and collagen IV in two groups were significantly lower than those before treatment (P <0.05). The above indexes of the experimental group after treatment were significantly lower than those of the control group (P <0.05). After treatment, serum creatinine and 25-hydroxyvitamin D 3 levels in both groups were significantly higher than those before treatment, and the above indexes in the experimental group were significantly higher than those in the control group (P <0.05). The incidence of adverse reactions in the control group was 23.53%, which was significantly higher than that in the experimental group (8.82%, P <0.05). Conclusion The efficacy of levocarnitine combined with alprostadil in the treatment of diabetic nephropathy is significant and safe.