Qin Lili, Qin Wenjun, Wang Jianfei, Lin Lin
Department of Nephrology, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China.
Department of Urology, Hanting People's Hospital of Weifang, Weifang, Shandong 261100, P.R. China.
Exp Ther Med. 2017 Nov;14(5):5012-5016. doi: 10.3892/etm.2017.5115. Epub 2017 Sep 12.
This study investigated the effects of alprostadil combined with calcium dobesilate on the treatment of diabetic nephropathy. We recruited 80 patients with diabetic nephropathy, who were randomly divided into experimental (n=40) and control (n=40) groups. Patients received high-quality low-protein diabetic diet intervention and subcutaneous injection of insulin to adjust blood glucose, combined with antihypertensive, antiplatelet drugs, and other comprehensive treatments. The control group received alprostadil and the experimental group received alprostadil combined with calcium dobesilate. Both groups were treated for 12 weeks as one treatment cycle. The time to remission of clinical symptoms such as mental fatigue and weakness, limb edema, soreness and swelling of waist and knee, cold limbs and limb numbness and pain was significantly shorter in the experimental group than that in the control group (p<0.05). After intervention, the blood levels of small molecular weight proteins, such as β2-microglobulin (β2-MG), cystatin C (CysC), and retinol binding protein (RBP), were significantly lower in the experimental group than those in the control group (p<0.05). The levels of the inflammatory cytokines tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and C-reactive protein (CRP) were significantly lower in the experimental group than those in the control group (p<0.05). The levels of 25-hydroxyvitamin D and parathyroid hormone were significantly higher in the experimental group than those in the control group (p<0.05). The level of angiotensin II was lower in the experimental group than that in the control group (p<0.05) and the level of fasting serum insulin was significantly higher in the experimental group than that in the control group (p<0.05). The homeostasis model assessment of insulin resistance (HOMA-IR) index was lower in the experimental group than that in the control group (p<0.05). The levels of renal function indexes, blood urea nitrogen, creatinine and uric acid, in experimental group were lower than those in control group (p<0.05). The levels of brain derived neurotrophic factor (BDNF) and insulin-like growth factor-1 (IGF-1) were significantly higher in both groups after the intervention than those before the intervention (p<0.05). The levels of BDNF and IGF-1 were higher in the experimental group than that in control group after intervention (p<0.05). The application of alprostadil combined with calcium dobesilate in patients with diabetic nephropathy can effectively relieve clinical symptoms, improve renal functions, reduce blood levels small proteins, alleviate the inflammatory response, and regulate the levels of BDNF and IGF-1, thus improving the clinical treatment effect.
本研究探讨前列地尔联合羟苯磺酸钙治疗糖尿病肾病的效果。我们招募了80例糖尿病肾病患者，将其随机分为实验组（n = 40）和对照组（n = 40）。患者接受优质低蛋白糖尿病饮食干预及皮下注射胰岛素以调节血糖，并联合使用降压、抗血小板药物等综合治疗。对照组接受前列地尔治疗，实验组接受前列地尔联合羟苯磺酸钙治疗。两组均以12周为一个治疗周期。实验组精神疲劳乏力、肢体水肿、腰膝酸痛、四肢冰凉及肢体麻木疼痛等临床症状缓解时间明显短于对照组（p<0.05）。干预后，实验组血中β2-微球蛋白（β2-MG）、胱抑素C（CysC）、视黄醇结合蛋白（RBP）等小分子蛋白水平明显低于对照组（p<0.05）。实验组炎症细胞因子肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、C反应蛋白（CRP）水平明显低于对照组（p<0.05）。实验组25-羟维生素D及甲状旁腺激素水平明显高于对照组（p<0.05）。实验组血管紧张素II水平低于对照组（p<0.05），实验组空腹血清胰岛素水平明显高于对照组（p<0.05）。实验组胰岛素抵抗稳态模型评估（HOMA-IR）指数低于对照组（p<0.05）。实验组肾功能指标血尿素氮、肌酐及尿酸水平低于对照组（p<0.05）。干预后两组脑源性神经营养因子（BDNF）及胰岛素样生长因子-1（IGF-1）水平均明显高于干预前（p<0.05）。干预后实验组BDNF及IGF-1水平高于对照组（p<0.05）。前列地尔联合羟苯磺酸钙应用于糖尿病肾病患者可有效缓解临床症状，改善肾功能，降低血中小分子蛋白水平，减轻炎症反应，调节BDNF及IGF-1水平，从而提高临床治疗效果。
