前列地尔联合氯吡格雷治疗早期糖尿病肾病疗效观察

目的:观察前列地尔与氯吡格雷联合治疗早期糖尿病肾病(DN)的临床疗效。方法:选择我院2013年10月至2014年10月期间收治的早期DN患者120例为研究对象,采用随机数表法将患者随机分为观察组62例和对照组58例,两组患者均给予血管紧张素受体拮抗剂(ARB)或血管紧张素转化酶抑制剂(ACEI)类药物1个月后,对照组给予前列地尔治疗,观察组给予前列地尔联合氯吡格雷治疗,两组患者均进行20d的治疗,观察并比较两组患者治疗前后β2-微球蛋白(β2-MG)、尿微量白蛋白(U-malb)、高敏C反应蛋白(hs-CRP)、尿素氮(BUN)、血肌酐(Cr)、平均动脉压(MPA),全血低切边率、全血高切变率、血浆粘滞度、血小板聚集率的变化情况及不良反应的发生情况。结果:治疗前两组患者间各项指标比较差异均无统计学意义(P0.05);治疗后两组患者β2-MG、U-malb、hs-CRP、血浆粘滞度、全血粘滞度、血小板聚集率较治疗前均出现明显降低,且观察组患者各项指标均低于对照组,差异均有统计学意义(P0.05);治疗前后两组患者Cr、BUN、MPA水平均未发生明显变化(P0.05);两组患者均未发生严重并发症。结论:早期DN患者给予前列地尔联合氯吡格雷治疗可以降低其尿蛋白,减轻炎症反应,缓解疾病进展,具有明显的临床疗效。

Observation Clinical Curative Effect of on Alprostadil with Clopidogrel inTreatment of Early Diabetic Nephropathy

Objective:To observe the clinical curative effect of on alprostadil with clopidogrel in treatment of early diabeticnephropathy.Methods:120 patients with early DN from October 2013 to October 2014 during the period were admitted as the researchobject, using the stochastic indicator method patients were randomly divided into observation group (62 cases) and control group (58cases), two groups of patients were given angiotensin receptor blockers (ARB) or angiotensin converting enzyme inhibitors (ACEI) drugswith one month, the control group were given alprostadil, observation group was given alprostadil combined with clopidogrel, two groupsof patients were treated for 20 d, the two groups before and after treatment in patients with beta 2 - microglobulin (beta 2-MG), urinetrace albumin (U-malb), high-sensitivity c-reactive protein (hs CRP) and blood urea nitrogen (BUN), creatinine (Cr), mean arterialpressure (MPA), whole blood low rate of trimming, whole blood high shear rate, plasma viscosity, platelet aggregation rate changes andthe occurrence of adverse reactions were observed and compared.Results:Before treatment, differences of the indicators between twogroups had no statistical significance (P>0.05); after treatment, beta 2-MG, U-malb, hs-CRP, plasma viscosity, whole blood viscosity,platelet aggregation rate in the two groups was significantly lower in the before treatment, the indicators in the observation group ofpatients were lower than the control group, differences were statistically significant (P<0.05); Cr, BUN, MPA level before treatment andafter treatment in Two groups of patients did not change obviously (P>0.05); there were not serious complications occurred in two groupsof patients.Conclusion:Alprostadil combinated with clopidogrel in treatment of early DN patients can lower the urine protein, reduceinflammation reaction, alleviate disease progression, it has obvious clinical efficacy.