| 杨栋民,陈洪波,刘占民,等.前列地尔对糖尿病肾病病人胱抑素 C、视黄醇结合蛋白、游离脂肪酸的影响[J].安徽医药,2019,23(12):2497-2500. |
| 前列地尔对糖尿病肾病病人胱抑素 C、视黄醇结合蛋白、游离脂肪酸的影响 |
| Effect of alprostadil on cystatin C，retinol?binding protein and free fatty acid in patients with type 2 diabetic nephropathy |
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| DOI：10.3969/j.issn.1009?6469.2019.12.042 |
| 中文关键词: 糖尿病肾病 前列地尔 胱抑素 C 视黄醇结合蛋白质类 脂肪酸类，非酯化 |
| 英文关键词: Diabetic nephropathies Alprostadil Cystatin C Retinol?binding proteins Fatty acids,nonesterified |
| 基金项目:河北省秦皇岛市科技计划项目(201703A182) |
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| 中文摘要: |
| 目的探讨前列地尔对 2型糖尿病肾病(T2DN)病人胱抑素 C(Cys?C)、视黄醇结合蛋白(RBP)、游离脂肪酸(FFA)的影响。方法选取 2016年 9月至 2018年 4月秦皇岛市工人医院 T2DN病人 92例作为研究对象，按照随机数字表法分为两组，各 46例。对照组行常规控糖治疗 +辅助治疗，对病人饮食进行低脂肪控制，根据病人具体情况进行降糖药物、降血压药物及蛋白尿治疗；观察组在对照组的基础上加用前列地尔治疗，成年人每天 1次，每次 1~2 mL(5~10 μg)，加入 10 mL 0.9%氯化钠溶液缓慢静脉滴注。两组均治疗 10 d。分别检测并比较两组病人用药前、用药 10 d后血糖水平、血脂水平、肾功能指标以及 Cys?C、RBP、FFA水平。结果用药后，观察组病人空腹血糖水平(5.79±0.69)mmol/L、HbA1c水平(7.33±0.76)%低于对照组空腹血糖水平(6.52 ±0.78)mmol/L、HbA1c水平(8.64±0.85)%(P＜0.05)。用药后，观察组三酰甘油水平(2.00±0.69)mmol/L、总胆固醇水平(4.01± 0.59)mmol/L及 LDL?C水平(3.41±0.70)mmol/L低于对照组三酰甘油水平(2.58±0.68)mmol/L、总胆固醇水平(5.34±0.52)mmol/L及 LDL?C水平(4.23±0.65)mmol/L，观察组 HDL?C水平(2.90±0.63)mmol/L高于对照组 HDL?C(2.32±0.69)mmol/L，均差异有统计学意义(均 P＜0.05)。用药后，观察组病人尿素氮水平(4.28±1.23)mmol/L、血肌酐水平(90.06±15.38)μmol/L、24 h UAER水平(40.28±6.30)μg/min低于对照组尿素氮水平(7.96±1.50)mmol/L、血肌酐水平(103.52±19.54)μmol/L、24 h UAER水平(99.34 ±8.77)μg/min(均 P＜0.05)。用药后，观察组病人 Cys?C水平(0.85±0.17)mg/L、RBP水平(39.26±4.87)mg/L、FFA水平(0.52± 0.21)mmol/L水平低于对照组 Cys?C水平(1.23±0.24)mg/L、RBP水平(48.33±5.03)mg/L、FFA水平(0.52±0.21)mmol/L(均 P＜ 0.05)。结论前列地尔治疗 T2DN病人，能够有效改善其血糖、血脂水平，降低肾功能指标以及 Cys?C、RBP、FFA水平。 |
| 英文摘要: |
| Objective To explore the effects of Alprostadil on cystatin C(Cys?C)，retinol binding protein(RBP)and free fatty ac?id(FFA)in patients with type 2 diabetic nephropathy(T2DN).Methods A total of 92 patients with T2DN in The QinhuangdaoWorkers Hospital between September 2016 and April 2018 were enrolled in the study.They were divided into two groups accordingto the random number table，with 46 cases in the observation group and 46 in the control group.The control group was treated withroutine glucose control therapy，the diet of the patients was controlled by low fat，and the patients were treated with hypoglycemic drugs，antihypertensive drugs and albuminuria according to the specific situation of the patients.And those in the observation grouptreated with Alprostadil based on treatment given to the control group.Adults were given a slow intravenous drip of 10 mL 0.9% so?dium chloride solution once a day for 1?2 mL(5?10 μg).Both groups were treated for 10 days.The levels of blood glucose，blood lipid，renal function and Cys?C，RBP，FFA were measured and compared between the two groups before and 10 days after treatment. Results After treatment，the fasting blood glucose level(5.79±0.69)mmol/L and HbA1c level(7.33±0.76)% in the observation group were both shown to be lower than the fasting blood glucose level(6.52±0.78)mmol/L and the HbA1c level(8.64±0.85)% in the control group，and the difference was statistically significant(P＜0.05).After treatment，the level of triacylglycerol(2.00 ± 0.69)mmol/L，total cholesterol level(4.01±0.59)mmol/L and LDL?C level(3.41±0.70)mmol/L in the observation group were shown to be lower than those in the control group，where the triacylglycerol was(2.58±0.68)mmol/L，total cholesterol level(5.34± 0.52)mmol/L and LDL?C level(4.23±0.65)mmol/L，and the HDL?C level(2.90±0.63)mmol/L in the observation group was shown to be higher than that in the control group，which was(2.32±0.69)mmol/L；the difference was statistically significant(P＜ 0.05).After treatment，the levels of urea nitrogen(4.28±1.23)mmol/L，serum creatinine(90.06±15.38)μmol/L，and 24h UAER(40.28±6.30)μg/min in the observation group were all shown to be lower than the control group，which were respectively(7.96± 1.50)mmol/L，(103.52±19.54)μmol/L and(99.34±8.77)μg/min，and the difference was statistically significant(P＜0.05).After treatment，the Cys?C level(0.85±0.17)mg/L，RBP level(39.26±4.87)mg/L，and FFA level(0.52±0.21)mmol/L in the observa? tion group were all shown to be lower than the control group，where the Cys?C level was(1.23±0.24)mg/L，RBP level(48.33± 5.03)mg/L，and FFA level(0.52±0.21)mmol/L；the difference was statistically significant(P＜0.05).Conclusion For patients with T2DN，Alprostadil can help improve blood glucose and blood lipid，their renal function indicators and the levels of Cys?C，RBP and FFA. |
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