贝前列素钠与缬沙坦联合治疗对糖尿病肾病患者糖脂代谢和肾功能的影响

Effects of beraprost sodium combined with valsartan on glycolipid metabolism and renal function in patients with diabetic nephropathy

摘要:

目的 探讨贝前列素钠与缬沙坦联合治疗对糖尿病肾病患者糖脂代谢和肾功能的影响。方法 回顾性分析2022年1月—2025年1月在川北医学院附属医院接受治疗的102例糖尿病肾病患者的临床资料，根据治疗方法不同将患者分为对照组和观察组。对照组共48例，接受缬沙坦治疗，观察组共54例，接受贝前列素钠与缬沙坦联合治疗，两组均治疗6个月。比较两组治疗前后的炎症因子［肿瘤坏死因子-α（TNF-α）、高敏C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）］水平、血糖［空腹血糖（FPG）、餐后2小时血糖（2h PPG）、糖化血红蛋白（HbA1c）］水平、血脂［甘油三酯（TG）、总胆固醇（TC）］水平、肾功能［血尿素氮（BUN）、血肌酐（Cr）、尿液24 h尿蛋白定量（24h-UP）］、肾血流动力学［收缩期峰值流速（V_smax）、舒张期峰值流速（V_dmax）、阻力指数（RI）］，记录患者用药期间不良反应发生情况。结果 观察组治疗后TNF-α、hs-CRP、IL-6均低于对照组（P <0.05）；观察组治疗前后TNF-α、hs-CRP、IL-6的差值均大于对照组（P <0.05）。观察组治疗后FPG、2h PPG、HbA1c均低于对照组（P <0.05）；观察组治疗前后FPG、2h PPG、HbA1c的差值均大于对照组（P <0.05）。观察组治疗后TC、TG均低于对照组（P <0.05）；观察组治疗前后TC、TG的差值均大于对照组（P <0.05）。观察组治疗后BUN、Cr、24h-UP均低于对照组（P <0.05）；观察组治疗前后BUN、Cr、24h-UP的差值均大于对照组（P <0.05）。观察组治疗后V_smax、V_dmax均高于对照组（P <0.05），RI低于对照组（P <0.05）；观察组治疗前后V_smax、V_dmax、RI的差值均大于对照组（P <0.05）。两组不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 贝前列素钠联合缬沙坦治疗糖尿病肾病可有效降低患者的炎症因子与血糖血脂水平，显著改善肾功能指标，且联合用药未增加不良反应发生风险。

Abstract:

Objective To investigate the effects of beraprost sodium combined with valsartan on glycolipid metabolism and renal function in patients with diabetic nephropathy.Methods The study subjects were 102 patients with diabetic nephropathy who received treatment at the Affiliated Hospital of North Sichuan Medical College from January 2022 to January 2025. According to different treatment methods, the patients were divided into a control group and an observation group. The control group, consisting of 48 cases, was treated with valsartan alone, while the observation group, with 54 cases, received combined treatment of beraprost sodium and valsartan. Both groups were treated for 6 months. The levels of inflammatory factors, blood glucose, blood lipid, renal function and renal hemodynamics of the two groups were compared before and after treatment, and the incidence of adverse reactions during medication was recorded in all patients.Results The post-treatment levels of TNF-α, hs-CRP, and IL-6 in the observation group were all lower than those in the control group(P < 0.05). The magnitude of change (difference) in TNF-α, hs-CRP, and IL-6 in the observation group was greater than that in the control group(P < 0.05). The post-treatment levels of FPG, 2h PPG, and HbA1c in the observation group were all lower than those in the control group (P < 0.05). The magnitude of change in FPG, 2h PPG, and HbA1c in the observation group was greater than that in the control group (P < 0.05). The post-treatment levels of TC and TG in the observation group were all lower than those in the control group (P < 0.05). The magnitude of change in TC and TG in the observation group was greater than that in the control group (P < 0.05). The post-treatment levels of BUN, Cr, and 24h-UP in the observation group were all lower than those in the control group (P < 0.05). The magnitude of change in BUN, Cr, and 24h-UP in the observation group was greater than that in the control group (P < 0.05). The post-treatment levels of Vsmax and Vdmax in the observation group were higher than those in the control group (P < 0.05), while RI was lower (P < 0.05). The magnitude of change in V_smax, V_dmax, and RI in the observation group was greater than that in the control group (P < 0.05). There was no statistically significant difference in the total incidence of adverse reactions between the control group and the observation group (P > 0.05).Conclusion Beraprost sodium combined with valsartan in the treatment of diabetic nephropathy can effectively reduce the levels of inflammatory factors, blood glucose and blood lipids in patients, significantly improve the renal function indicators, and the combined medication does not increase the risk of adverse reactions.