舒洛地特联合贝前列素钠治疗糖尿病肾病的疗效观察

Curative effect of Sulodexide combined with Beraprost sodium in treatment of diabetic nephropathy

摘要:

目的 观察舒洛地特联合贝前列素钠治疗糖尿病肾病（DN）的临床疗效。方法 选取牡丹江医学院 附属红旗医院收治的DN 患者96 例。随机分为3 组，每组32 例。在常规治疗的基础上，舒洛地特组口服舒洛地 特胶囊；贝前列素钠组口服贝前列素钠片；联合治疗组口服舒洛地特胶囊和贝前列素钠片。8 周后，分别观察 3 组患者的临床有效率，治疗前后24 h 尿蛋白定量（24 h-UTP）、尿白蛋白排泄率（UAER）、尿β2 微球蛋 白（β2-MG）、血清胱抑素C（Cys C）、纤维蛋白原（FIB）、血浆纤溶酶原激活剂抑制物1（PAI-1）及D- 二聚体（D-D）的水平变化。结果 8 周后，联合治疗组有效率与舒洛地特组和贝前列素钠组比较，差异无统 计学意义（P >0.05）。8 周后，舒洛地特组的24 h-UTP、UAER、Cys C 及FIB 较治疗前下降（P <0.05）；贝 前列素钠组的24 h-UTP、β2-MG、Cys C 及D-D 较治疗前下降（P <0.05）；联合治疗组的UAER、β2- MG、24 h-UTP、Cys C、PAI-1、FIB 及D-D 较治疗前下降（P <0.05）。联合治疗组的24 h-UTP、β2- MG、FIB 及D-D 与舒洛地特组比较，差异有统计学意义（P <0.05）；联合治疗组的24 h-UTP、UAER、FIB 及D-D 与贝前列素钠组比较，差异有统计学意义（P <0.05）。结论 舒洛地特联合贝前列素钠治疗DN，能有 效减少尿蛋白形成，改善肾脏微循环高凝状态、纤溶活性，延缓DN 进展，具有肾脏保护作用，且不良反应较 少，是治疗DN 的有效方法之一，值得临床推广应用。

Abstract:

Objective To observe the curative effect of Sulodexide combined with Beraprost sodium in treatment of diabetic nephropathy (DN). Methods A total of 96 cases of DN in our hospital were divided randomly into 3 groups, 32 cases for each group. On the basis of conventional therapy, the groups were further divided into Sulodexide group (oral Sulodexide), Beraprost sodium group (oral Beraprost sodium) and combination group (oral Sulodexide and Beraprost sodium). The clinical efficacy of the 3 groups were observed after 8 weeks of treatment. Levels of 24-hour urine protein quantitative (24 h-UTP), urine albumin excretion rate (UAER), urine 2 microspheres protein (2-MG), serum cystatin C (Cys C), fibrinogen (FIB), plasma plasminogen activator inhibitor 1 (PAI-1) and D-Dimer (D-D) were observed pre- and post-treatment. Results Eight weeks later, the clinical efficacy of combination group was compared with Sulodexide group and Beraprost sodium group, but there was no significant difference, respectively (P > 0.05). Post-treatment levels of 24 h-UTP, UAER and Cys C in Sulodexide group,24 h-UTP, 2-MG and Cys C in Beraprost sodium group and UAER, 24 h-UTP, Cys C and 2-MG in combination group decreased significantly than their pre-treatment ones (P < 0.05), respectively. Eight weeks later, there were significant differences for levels of 24 h-UTP, 2-MG, FIB and D-D in combination group compared with Sulodexide group (P < 0.05); there were significant differences for 24 h-UTP, UAER, FIB and D-D in combination group compared with Beraprost sodium group (P < 0.05). Conclusions Sulodexide combined with Beraprost sodium in treatment of DN can reduce the formation of urinary protein effectively, improve the renal vascular high coagulation state and fibrinolytic activity, delay the progress of DN and protect kidney. Meanwhile, the side effects are less, which is an effective treatment of DN.