贝前列素钠对糖尿病肾病尿白蛋白/肌酐比值及血管内皮功能的影响

目的观察贝前列素钠对早期糖尿病肾病尿白蛋白/肌酐比值(UACR)及血管内皮功能的影响。方法 2型糖尿病肾病(DN)Ⅲ期患者64例,随机分为2组:对照组32例口服厄贝沙坦150 mg/次,每日1次;治疗组32例口服厄贝沙坦150 mg/次(每日1次)+贝前列素钠40μg/次(每日3次),疗程均为4周。评估2组治疗前后UACR、血浆同型半胱氨酸(Hcy)、血浆内皮素(ET-1)和血清一氧化氮(NO)的变化。结果与治疗前比较,2组治疗后UACR(mg/g)均下降(治疗组212±121 vs 111±56,对照组214±125 vs 168±65,均为P<0.05);且治疗组下降较对照组更为明显(P<0.05);治疗组的Hcy、ET-1降低,NO明显升高,分别为(19.0±3.2)μmol/L vs(14.2±2.6)μmol/L;(79.1±9.9)ng/L vs(45.2±9.2)ng/L;(47.6±8.5)μmol/L vs(89.0±9.4)μmol/L,均为P<0.05],而对照组无显著改善(P>0.05)。结论贝前列素钠能显著降低早期糖尿病肾病的尿白蛋白/肌酐比值,改善血管内皮功能,且具有良好的安全性。

Effect of baraprost sodium on urinary-to-albumin creatinine ratio and vascular endothelial function in patients with diabetic nephropathy

Objective To observe the effect of baraprost sodium on urinary albumin-to-creatinine ratio(UACR) and vascular endothelial function in patients with early diabetic nephropathy.Methods Sixty-four cases with early diabetic nephropathy were randomly divided into two groups;control group was treated with 150 mg irbesartan,while treatment group with irbesartan and 40μg baraprost sodium for three times per day.Before and after the treatment of 4 weeks,UACR,homocystetine (Hcy),endothelia(ET-1) and nitric oxide(NO) were detected.Results After the treatment,the levels of UACR(mg/ g) in the two groups significantly decreased(212±121 vs 111±56 in treatment group and 214±125 vs 168±65 in control group respectively,P<0.05),and lower in treatment group than that in control group(P<0.05).In treatment group Hcy and ET-1 significantly decreased,while NO significantly increased(1.91±3.2)μmol/L vs(14.2±2.6)μmol/L;(79.1±9.9)ng/L vs(45.2±9.2)ng/L;(47.6±8.5)μmol/L vs(89.0±9.4)μmol/L,P<0.05)],but no obvious changes in control group(P>0.05).Conclusion Treatment of baraprost sodium could decrease the level of UACR,improve vascular endothelial function in patients with early diabetic nephropathy.