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目的:通过应用银杏达莫注射液联合前列地尔注射液治疗糖尿病肾病III-IV期患者,观察其疗效及对患者脂联素的影响,探讨其治疗机制。方法:选择2010年1月至2012年3月在我院住院治疗的80例,根据WHO糖尿病诊断标准和国际通用的Mbgensen分期标准诊断为糖尿病肾病III-IV期患者,所有入选者均应用胰岛素控制血糖,空腹血糖FBG5-7mmol/l之间,餐后2小时血糖(2hPG)5.0-10.0mmol/l之间,治疗前化验24小时尿白蛋白排泄率(24hUAER)、脂联素(APN),患者入院后联合治疗组给予银杏达莫注射液20ml加入生理盐水250ml静脉滴注联合前列地尔注射液10ug加入生理盐水100ml静脉滴注,每日1次,各组均持续治疗14天后,复查治疗后24小时尿白蛋白排泄率(24hUAER)、脂联素(APN),各项指标数据均以x±s表示,结果用PEM3.1软件版医学统计软件处理数据,比较治疗前、后各项指标的变化。结果:治疗后患者24小时尿白蛋白排泄率(24hUAER)与治疗前比较明显下降(P<0.05),治疗后患者脂联素(APN)与治疗前比较有明显升高(P<0.05)。结论:糖尿病肾病III-IV期患者肾小球弥漫性、结节性硬化,肾脏高灌注、高滤过,肾小球基底膜增厚、肾小球系膜区基质沉积,导致结节性或慢性肾小球硬化出现蛋白尿,导致的肾损害,应用银杏达莫注射液联合前列地尔注射液治疗后患者24小时尿白蛋白排泄率(24hUAER)明显下降,患者脂联素(APN)有明显升高,较单用银杏达莫注射液及前列地尔注射液临床治疗效果更佳,考虑与银杏达莫注射液联合前列地尔注射液能更好地发挥协同作用,影响糖尿病肾病相关炎症因子,从而达到更好的治疗效果。两者联合治疗临床效果优于单独用药治疗组,值得临床推广应用。
OBJECTIVE: To observe the curative effect and the effect on adiponectin in patients with stage III-IV of diabetic nephropathy by using the combination of Yinxingdamo injection and alprostadil injection, and to explore its therapeutic mechanism. Methods: Eighty patients hospitalized in our hospital from January 2010 to March 2012 were selected and diagnosed as stage III-IV diabetic nephropathy according to the diagnostic criteria of WHO diabetes and the internationally accepted Mbgensen staging system. All the patients were treated with insulin control Blood glucose, fasting blood glucose FBG5-7mmol / l, 2h postprandial blood glucose (2hPG) 5.0-10.0mmol / l, 24h urinary albumin excretion rate (24hUAER), adiponectin (APN) After admission, the patients in the combined treatment group were given ginkgo dipyridamole injection 20ml, saline 250ml, intravenous infusion of alprostadil 10ug, saline 100ml, once a day for 14 days, 24 hours after urinary albumin excretion rate (24hUAER), adiponectin (APN), the indicators of the data are x ± s said, the results using PEM3.1 software version of the medical statistics software to deal with the data before and after treatment of the items Changes in indicators. Results: After 24 hours, the urinary albumin excretion rate (24hUAER) decreased significantly (P <0.05). The APN level in patients after treatment was significantly higher than that before treatment (P <0.05). CONCLUSIONS: Glomerular diffuse, tuberous sclerosis, high renal perfusion, hyperfiltration, thickening of glomerular basement membrane and glomerular mesangial matrix deposition in patients with stage III-IV diabetic nephropathy lead to nodular or Patients with chronic glomerulosclerosis had proteinuria and renal damage. The 24-hour urinary albumin excretion rate (24hUAER) was significantly decreased after treatment with ginkgo-dipyridolum injection and alprostadil injection. Patients with adiponectin (APN) had Was significantly higher than the single use of gingko Damo injection and alprostadil injection clinical effect is better, consider and gingko Damo injection alprostadil injection synergy can play a better role, the impact of diabetic nephropathy-related inflammation Factor, so as to achieve better therapeutic effect. The combined treatment of both the clinical effect is superior to the single drug treatment group, it is worth clinical application.