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目的 探讨老年糖尿病早期肾病患者尿血栓素 B2 (Tx B2 )和 6 酮 前列腺素 F1α(6 Keto PGF1α)的变化及其意义 ,并观察大黄 虫丸对患者尿白蛋白排泄率 (UAER)和上述指标的影响。方法 根据 UAER将 73例老年糖尿病患者分为糖尿病无肾病组 (糖尿病组 )和早期糖尿病肾病组 (糖肾组 ) ,并与健康老年人对照 ;糖肾组分为对照组 (降低血糖西药 )和治疗组 (降低血糖西药和大黄 虫丸 )。结果 糖尿病组和糖肾组的空腹血糖 (FPG)均高于健康组 (P<0 0 0 1 ) ,糖肾组的 UAER显著高于其余两组 (P<0 0 0 1 ) ;两组治疗后 ,FPG和 UAER水平明显下降 (P<0 0 5～ 0 0 0 1 ) ,治疗组的差值明显大于对照组 (P<0 0 0 1 )。糖肾组尿 Tx B2 6 Keto PGF1α比值高于健康组 (P<0 0 0 1 )和糖尿病组 (P<0 0 1 ) ;对照组治疗后 ,指标变化不明显 (P>0 0 5) ,治疗组治疗后 ,Tx B2 和 Tx B2 6 Keto PGF1α比值均明显下降 (P<0 0 1～ 0 0 0 1 ) ,治疗组 Tx B2 和 Tx B2 6 Keto PGF1α的差值大于对照组 (P<0 0 1～ 0 0 0 1 )。结论 老年糖尿病早期肾病患者肾脏 Tx A2 PGI2 平衡失调 ;大黄 虫丸对其有明显的调节作用 ,这可能是该药治疗糖尿病早期肾病的机制之一。
Objective To investigate the changes and clinical significance of urinary TXB2 and 6 Keto PGF1α in patients with senile diabetic nephropathy and to observe the effect of rhubarb worm on urinary albumin excretion rate (UAER) Impact. Methods According to UAER, 73 cases of elderly diabetic patients were divided into diabetic nephropathy group (diabetic group) and early diabetic nephropathy group (diabetic nephropathy group), and compared with healthy elderly people. The control group (lower blood sugar western medicine) and Treatment group (lower blood sugar Western medicine and rhubarb worm pills). Results The fasting blood glucose (FPG) in diabetic group and sugar-kidney group were significantly higher than those in healthy group (P <0.01). The UAER in diabetic group was significantly higher than that in the other two groups (P <0.01) FPG and UAER levels decreased significantly (P <0.05-0.001), and the difference between the treatment group and the control group was significantly greater than that of the control group (P <0.01). The ratio of Tx B2 6 Keto PGF1α in diabetic kidney group was higher than that in healthy group (P <0.01) and diabetic group (P <0.01), while the index in control group was not significantly changed (P> 0.05) After treatment, the ratio of Tx B2 to Tx B2 6 Keto PGF1α was significantly decreased (P <0.01-0.01), and the difference between Tx B2 and Tx B2 6 Keto PGF1α in the treatment group was greater than that in the control group (P <0 0 1 ~ 0 0 0 1). Conclusion The kidney of elderly patients with diabetic nephropathy Tx A2 PGI2 imbalance; rhubarb worm pill has a significant regulatory effect, which may be the drug for the treatment of early diabetic nephropathy one of the mechanisms.