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目的 观察早期短时间联合应用前列地尔 (PGE1,凯时 )和洛汀新 (ACEI)对糖尿病早期肾病的尿蛋白的影响。方法 选取 2 0 0 2 - 0 4～ 2 0 0 3- 0 4河北医科大学第四医院糖尿病早期肾病患者 6 3例 ,年龄 4 3～ 6 8岁 ,随机分为联合用药组 32例 ,洛汀新组 31例。两组控制血压、血糖方法相同 ,均服用洛汀新 10mg ,每日 1次。联合用药组静脉滴注PGE110 μg ,每日 1次 ,连续 14d。 结果 和洛汀新组相比 ,联合用药组于治疗 2周后 2 4h尿蛋白及白蛋白排泄率明显降低 (P <0 0 5 ) ,治疗后 6个月尿蛋白仍维持于较低水平。洛汀新组仅在治疗 6个月后尿蛋白较前明显减少 (P <0 0 5 )。结论 在糖尿病早期肾病阶段 ,早期联合应用PGE1和洛汀新可快速降低尿白蛋白排泄率 ,并使尿蛋白长期维持于低水平 ;避免多疗程应用PGE1,减少医疗开支 ,减轻医疗负担。
Objective To observe the effect of early and short-term combined application of alprostadil (PGE1, triamcinolone acetonide) and ACEI on urinary protein in early diabetic nephropathy. Methods Totally 63 patients with early diabetic nephropathy at the Fourth Hospital of Hebei Medical University from 2004 to 2004 were enrolled. The patients were aged from 43 to 68. They were randomly divided into combined treatment group (n = 32), Lotensin New group of 31 cases. Two control blood pressure, blood sugar the same method, taking Lotensin 10mg, 1 day. Combination therapy group intravenous infusion of PGE110 μg once daily for 14 days. Results Compared with the Lotensin group, urinary protein and albumin excretion rate decreased significantly (P <0.05) at 24 hours after treatment in the combination group and remained at a low level at 6 months after the treatment. In the Lotensin group, urinary protein was significantly reduced only 6 months after treatment (P <0.05). Conclusion Early application of PGE1 and Lotensin in the early phase of diabetic nephropathy can rapidly decrease the urinary albumin excretion rate and maintain the urinary protein at a low level for a long time. Avoid multiple courses of application of PGE1, reduce medical expenses and reduce the medical burden.