前列地尔联合缬沙坦治疗慢性肾小球肾炎的临床疗效观察

目的观察前列地尔联合缬沙坦治疗慢性肾小球肾炎的临床疗效及对肾功能及血液流变学的影响。方法将确诊为慢性肾小球肾炎的78例患者按随机数字表分为观察组39例和对照组39例，两组均进行常规方法治疗，对照组口服缬沙坦80mg／次，q．d．，观察组在对照组的基础上再静脉滴注前列地尔治疗，10蚓次，q．d．，2周为1个疗程，两组均治疗2个疗程，每个疗程间隔7d，治疗前后观察两组患者肾功能（24h尿蛋白排泄量Upro、血肌酐Scr、尿素氮BUN）及血液流变学（全血高切黏度、全血低切黏度）的改善情况，评价两组临床疗效。结果观察组和对照组治疗后Upro、Scr、BUN均较治疗前明显下降（P〈0．05），治疗后观察组Upro、Scr、BUN明显低于对照组（P〈0．05）；观察组和对照组治疗后全血高切黏度、全血低切黏度均较治疗前明显下降（P〈0．05），治疗后观察组全血高切黏度、全血低切黏度明显低于对照组（P〈0．05）；观察组和对照组的总有效率分别为89．74％（35／39）和56．41％（22／39），差异具有统计学意义（x2=12．123，P〈O．01）。结论前列地尔联合缬沙坦治疗慢性肾小球肾炎的临床疗效确切，能够有效改善肾功能及血液流变学指标，降低肾血管阻力，延缓肾功能恶化，值得临床推广使用。

Clinical observation on effect of alprostadii and valsartan in the treatment of chronic glomerulonephritis

Objective To observe the effect of alprostadil and valsartan in the treatment of chronic glomerulonephritis and its influence on renal function and blood rheology. Methods From January 2012 to November 2013, 78 patients with chronic glomerulonephritis were randomly divided into observation group andcontrol group, 39 cases for each group, both groups were given conventional therapy, control group added calsartan, 80 mg/time, q.d., observation group was given alprostadil, 10 μg/time, q.d., 2 weeks for a course, both groups had been treated for two courses, next course interval 7 d, renal function （Upro, Scr, BUN） and blood rheology （high shear whole blood viscosity, low shear whole blood viscosity） were detected before and after treatment, evaluated the clinical efficacy of both group. Results Upro, Scr and BUN of both groups after treatment were significantly lower than before treatment（P〈0.05）; Upro, Scr and BUN of observation group after treatment were significantly lower than control group（P〈0.05）; high shear whole blood viscosity and low shear whole blood viscosity of both group after treatment were significantly lower than before treatment（P〈0.05）; high shear whole blood viscosity and low shear whole blood viscosity of observation group after treatment were significantly lower than control group（P〈0.05）; the total effective rate of observation group and control group were respectively 89.74% （35/39） VS 56.41% （22/39）, the difference was statistically significant （X2= 12.123, P〈0.01）. Conclusion Alprostadil and valsartan have exact clinical efficacy in the treatment of chronic glomerulonephritis, which can effectively improve renal function and blood rheology, reduce renal vascular resistance and delay deterioration of renal function, so it is worthy of clinical promotion.