前列地尔注射液联合吡格列酮治疗早期糖尿病肾病的临床观察

目的：探讨前列地尔注射液联用吡格列酮对糖尿病肾病（DN）早期的临床治疗效果.方法：纳入180例DN早期患者,按随机单盲法分为三组.在糖尿病的基础治疗的前提下,前列地尔组60例患者静脉注射前列地尔,吡格列酮组60例患者口服吡格列酮,联合组60例患者二者联用.三组均治疗1个疗程,4周为1个疗程,观察其肾功能及尿蛋白指标,包括血尿素氮（BUN）、血肌酐（Scr）、24 h尿蛋白量（Upr）、尿微量清蛋白（UAER）、血清同型半胱氨酸（Hcy）和β2-微球蛋白（β2-MG）；血脂指标包括血清总胆固醇（TC）、甘油三脂（TG）、高密度脂蛋白胆固醇（HDL-C）、和低密度脂蛋白胆固醇（LDL-C）.结果：三组患者治疗后BUN、Scr、Upr、UAER、Hcy和尿β2-MG均下降（P＜0.05）,且联合组治疗后BUN、Scr、Upr、UAER、Hcy和尿β2-MG水平均低于前列地尔组及吡格列酮组（P＜0.05）.三组患者治疗后TC、TG、HDL-C和LDL-C均显著下降（P＜ 0.01）,且联合组低于前列地尔组及吡格列酮组（P＜0.05）.结论：前列地尔注射液联合吡格列酮治疗早期DN的疗效显著,优于单用前列地尔注射液和吡格列酮.

Clinical observation of alprostadil injection combined with pioglitazone on early diabetic nephropathy

Objective：To explore the effect of alprostadil injection combined with pioglitazone on early diabetic nephropathy.Methods：One hundred and eighty patients were divided into 3 groups.One group was treated with alprostadil injection,one group with pioglitazone,while another group with alprostadil injection combined with pioglitazone.The change of parameters of blood fat （TC,TG,HDL-C,and LDL-C） and renal function （BUN,Scr,Upr,UAER,Hcy,and β2-MG） was detected before and after the treatment.Results：BUN,Scr,Upr,UAER,Hcy,and β2-MG decreased significantly in three groups （P＜0.05）,and patients treated with alprostadil injection combined with pioglitazone had better BUN,Scr,Upr,UAER,Hcy,and β2-MG than patients in the other two groups （P＜0.05）.TC,TG,HDL-C,and LDL-C improved significantly after the treatment （P＜0.01）,and patients treated with alprostadil injection combined with pioglitazone had better TC,TG,HDL-C,and LDL-C than patients in the other two groups （P＜0.05）.Conclusion：The improvement effect of alprostadil injection combined with pioglitazone on early diabetic nephropathy is obvious and is better than alprostadil injection or Pioglitazone alone.