前列腺素E1在糖尿病肾病不同时期的疗效观察

目的 观察前列腺素E1(PGEl)治疗老年人糖尿病肾病的疗效.方法 将糖尿病肾病Ⅲ、Ⅳ、Ⅴ期患者随机分为4组,即对照组和PGE1、PGE1+血管紧张素转换酶抑制剂(ACEI)及ACEI不同治疗方案的治疗组,测定各组治疗前及治疗后15 d、3个月、6个月时24 h尿蛋白和24 h尿微量白蛋白.结果 (1)在糖尿病肾病Ⅲ期及Ⅳ早期(尿蛋白＜2.5 g/d)患者中,PGEl+ACEI组和PGE1组治疗15天、3个月、6个月时尿蛋白及尿微量白蛋白均明显下降(P＜0.01),比对照组及ACEI组下降大于10%;(2)在糖尿病肾病Ⅳ晚期(尿蛋白＞2.5 g/d)患者中,PGE1+ACEI组及PGE1组尿蛋白和尿微量白蛋白治疗后3个月、6个月时效果不如Ⅳ早期,而对照组均增加10%以上(P＜0.05或P＜0.01);(3)在糖尿病肾病V期患者中,治疗组治疗后15 d、3个月及6个月时尿蛋白及尿微量白蛋白下降程度明显减慢;对照组治疗3个月及6个月后,上述2项指标增加10%以上(P＜0.01).结论 前列腺素E1对糖尿病肾病具有较好治疗效果,且对早期糖尿病肾病治疗效果优于晚期.

Therapeutic effects of prostaglandin E1 on diabetic nephropathy in different periods in the elderly people

Objective To investigate the effects of prostaglandin E1(PGEl)in improving proteinuria and albuminuria in the elderly people with diabetic nephropathy(DN). Methods Patients including stage Ⅲ,stage Ⅳ and stage Ⅴ were divided into four groups:conventional therapy group,PGE1 group,PGE1+ACEI group and ACEI group.Proteinuria and albuminuria were measured before and after treatment for 15 days,3 months,6 months. Results (1)In the DN patients in stage Ⅲ and stage Ⅳ (proteinuria＜2.5 g/d),the proteinuria and albuminuria descended markedly in PGE1+ACEI and PGEl group(P＜0.01).It was better than that in eonventionaI therapy and ACEI group.(2)In the DN patients in stage Ⅳ(proteinuria＞2.5 g/d),proteinuria and albuminuria were not changed significantly after 3 months and 6 months in PGE1+ACEI and PGE1 group,but they were increased in conventional group(P＜0.05).(3)In the DN patients in stage Ⅴ,the proteinuria and albuminuria were not changed much after 1 5 days,3 months and 6 months(P＜0.05).The proteinuria and albuminuria were increased by more than 10 percent(P＜0.01)in the conventional group after 3 and 6 months. Conclusions The therapeutic effects of PGE1 are obvious.Early treatment of nephropathy will get a better improvement in patients with diabetic nephropathy.