2018 年第 10 期 第 13 卷

贝前列素钠对糖尿病肾病患者尿白蛋白水平的影响

Effect of beraprost sodium on urinary albumin in patients with diabetic nephropathy

作者：杨丽娟班安然陶红

英文作者：

单位：100029首都医科大学附属北京安贞医院内分泌代谢科

英文单位：

关键词：糖尿病肾病；贝前列素钠；白蛋白尿

英文关键词：

• 摘要：

• 【摘要】目的    探讨贝前列素钠对糖尿病肾病患者尿白蛋白水平的影响。方法    选择2016年1月至2017年6月就诊于首都医科大学附属北京安贞医院内分泌代谢科的尿白蛋白/肌酐比值30~300 mg/g的糖尿病肾病患者196例，根据是否应用贝前列素钠分为观察组及对照组，各98例。对照组在基础疾病治疗基础上口服替米沙坦40 mg，1次/d，疗程3个月。观察组在对照组治疗基础上给予贝前列素钠40 μg口服，3次/d，共3个月。比较2组患者的一般资料、治疗前和治疗3个月后尿白蛋白/肌酐比值、炎症指标、凝血功能、肝肾功能以及药物不良反应发生情况。结果    2组患者一般资料比较差异均无统计学意义(均P>0.05)。治疗前，2组患者尿白蛋白/肌酐比值比较差异无统计学意义(P>0.05);治疗3个月后，观察组与对照组患者尿白蛋白/肌酐比值均低于治疗前［(112±53)mg/g比(204±93)mg/g，(158±61)mg/g比(202±95)mg/g］，且观察组低于对照组，差异均有统计学意义(均P<0.05)。治疗前,2组患者炎症指标及凝血功能比较差异均无统计学意义(均P>0.05)；治疗3个月后，2组患者高敏C反应蛋白、D-二聚体、纤维蛋白原均低于治疗前，且观察组低于对照组［(6.7±0.5)mg/L比(8.9±0.8)mg/L，(0.51±0.22)μg/L比(0.84±0.36)μg/L，(2.6±0.4)g/L比(3.1±0.6)g/L］，差异均有统计学意义(均P<0.05)。2组患者治疗前后肝肾功能指标和药物不良反应发生率比较差异均无统计学意义(均P>0.05)。结论    贝前列素钠治疗对于降低糖尿病肾病患者尿白蛋白水平有效，与替米沙坦联合应用效果优于单用替米沙坦，作用机制可能与抑制炎性反应及改善高凝状态有关。

• 【Abstract】Objective    To investigate the effect of beraprost sodium on urinary albumin in patients with diabetic nephropathy. Methods    One hundred and ninety-six patients with diabetic nephropathy, urine albumin/creatinine ratio(ACR) 30-300 mg/g, who visited Department of Endocrinology and Metabolism, Beijing Anzhen Hospital, Capital Medical University from January 2016 to June 2017 were included. They were divided into observation group and control group, with 98 patients in each group. The control group took 40 mg telmisartan 1 time per day. The observation group took telmisartan plus 40 μg beraprost sodium 3 times per day. Both groups were treated for 3 months. Basic clinical information, ACR, inflammation, blood coagulation, liver and renal function indexes were analyzed. Adverse drug reactions were observed. Results    Basic clinical information, ACR, inflammation and blood coagulation indexes before treatment showed no significant differences between groups(P>0.05). After treatment, ACR was significantly lower than that before treatment in both observation group and control group［(112±53)mg/g vs (204±93)mg/g， (158±61)mg/g vs (202±95)mg/g］ and there was a significant difference between the two groups(P<0.05). Serum levels of high-sensitivity C-reactive protein, D-dimer and fibrinogen significantly decreased after treatment compared to those before treatment; levels of high-sensitivity C-reactive protein, D-dimer and fibrinogen in observation group were significantly lower than those in control group［(6.7±0.5)mg/L vs (8.9±0.8)mg/L， (0.51±0.22)μg/L vs (0.84±0.36)μg/L， (2.6±0.4)g/L vs (3.1±0.6)g/L］(P<0.05). Liver and renal function indexes and incidence of adverse drug reactions showed no significant differences between groups(P>0.05). Conclusions    Beraprost sodium can effectively lower urinary albumin level in diabetic nephropathy patients. Beraprost sodium plus telmisartan shows a better therapeutic effect on diabetic nephropathy than telmisartan alone.