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目的:观察前列地尔与氯吡格雷联合治疗早期糖尿病肾病(DN)的临床疗效。方法:选择我院2013年10月至2014年10月期间收治的早期DN患者120例为研究对象,采用随机数表法将患者随机分为观察组62例和对照组58例,两组患者均给予血管紧张素受体拮抗剂(ARB)或血管紧张素转化酶抑制剂(ACEI)类药物1个月后,对照组给予前列地尔治疗,观察组给予前列地尔联合氯吡格雷治疗,两组患者均进行20d的治疗,观察并比较两组患者治疗前后β2-微球蛋白(β2-MG)、尿微量白蛋白(U-malb)、高敏C反应蛋白(hs-CRP)、尿素氮(BUN)、血肌酐(Cr)、平均动脉压(MPA),全血低切边率、全血高切变率、血浆粘滞度、血小板聚集率的变化情况及不良反应的发生情况。结果:治疗前两组患者间各项指标比较差异均无统计学意义(P>0.05);治疗后两组患者β2-MG、U-malb、hs-CRP、血浆粘滞度、全血粘滞度、血小板聚集率较治疗前均出现明显降低,且观察组患者各项指标均低于对照组,差异均有统计学意义(P<0.05);治疗前后两组患者Cr、BUN、MPA水平均未发生明显变化(P>0.05);两组患者均未发生严重并发症。结论:早期DN患者给予前列地尔联合氯吡格雷治疗可以降低其尿蛋白,减轻炎症反应,缓解疾病进展,具有明显的临床疗效。
Objective: To observe the clinical efficacy of alprostadil combined with clopidogrel in the treatment of early diabetic nephropathy (DN). Methods: A total of 120 patients with early DN who were treated in our hospital from October 2013 to October 2014 were selected as the study subjects. The patients were randomly divided into observation group (62 cases) and control group (58 cases) using random number table method. Both groups One month after the administration of angiotensin receptor blocker (ARB) or angiotensin-converting enzyme inhibitor (ACEI), the control group was treated with alprostadil, and the observation group was treated with alprostadil plus clopidogrel. Two The patients in the two groups were treated for 20 days. The levels of β2-microglobulin, U-malb, hs-CRP and BUN in both groups were observed and compared before and after treatment. (BUN), serum creatinine (Cr), mean arterial pressure (MPA), whole blood low shear rate, whole blood high shear rate, plasma viscosity, platelet aggregation rate and incidence of adverse reactions. Results: There was no significant difference between the two groups before treatment (P> 0.05). After treatment, β2-MG, U-malb, hs-CRP, plasma viscosity, (P <0.05). The levels of Cr, BUN and MPA in both groups before and after treatment were significantly lower than those before treatment No significant changes (P> 0.05); no serious complications occurred in both groups. Conclusion: Alzheimer’s combined with clopidogrel in patients with early DN can reduce urinary protein, reduce inflammation and relieve disease progression, with obvious clinical efficacy.