Clinical effect of Pioglitazone combined with Alprostadil in treating diabetic nephropathy
ZHONG Dingliang1 MO Xiaoqing2
1.Department of Pharmacy, Zhujiang Hospital of Southern Medical University, Guangdong Province, Guangzhou 510280, China;
2.Department of Endocrinology, Central People's Hospital of Zhanjiang, Guangdong Province, Zhanjiang 524237, China
Abstract:Objective To investigate the clinical effect of Pioglitazone combined with Alprostadil in treating diabetic nephropathy (DN). Methods From May 2015 to February 2017, 98 patients with DN in Zhujiang Hospital of Southern Medical University were divided into treatment group and control group by random number table, with 49 cases in each group. The treatment group was treated with Pioglitazone and Alprostadil, while the control group was treated with Pioglitazone, continuous treatment for 6 months. The levels of high sensitivity C-reactive protein (HS-CRP), glycosylated hemoglobin (HbA1c), serum creatinine (Scr), urea nitrogen (BUN), serum cystatin C (Cys-C), 24-hour urinary albumin (24 h UAE), serum adipose-specific serine protease inhibitor (Vaspin), insulin resistance index (HOMA-IR) were analyzed before and after treatment in both groups. Results Before treatment, there were no statistically significant differences in the levels of HS-CRP, HbA1c, Scr, BUN, Cys-C, Vaspin, HOMA-IR, 24 h UAE between the two groups (P > 0.05). Six month after treatment, all of these indicators were improved in the two groups, and those of the treatment group were better than those of the control group, with statistically significant difference (P < 0.05). There was no statistically significant difference in the adverse effects rate between the two groups(P > 0.05). Conclusion The clinical effect of Pioglitazone combined with Alprostadil in treating diabetic nephropathy is better, which is worthy of clinical application.
[1] 刘新民.实用内分泌学[M].3版.北京:人民军医出版社,2004.
[2] 赵龙,关广聚.糖尿病肾病发病机制研究进展[J].中华肾脏病杂志,2013,29(7):554-558.
[3] Pavkov ME,Knowler WC,Hanson RL,et al. Comparison of serum cystatin C,serum creatinine,measured GFR,and estimated GFR to assess the risk of kidney failure in American Indians with diabetic nephropathy [J]. Am J Kidney Dis,2013,62(1):33-41.
[4] Derosa G,Ragonesi PD,Fogari E,et al. Sitagliptin added to previously taken antidiabetic agents on insulin resistance and lipid profile:a 2-year study evaluation [J]. Fundam Clin Pharmacol,2014,28(2):221-229.
[5] Moresco RN,Sangoi MB,De Carvalho JA,et al. Diabetic nephropathy:traditional to proteomic markers [J]. Clin Chim Acta,2013,421(6):17-30.
[6] 洪洁,宁光,王笑微,等.减少样本数的Bergman最小模型技术在胰岛素抵抗综合征中的应用[J].中华内分泌代谢杂志,2000,16(6):358-362.
[7] 余益本,吴移谋,文格波.吡格列酮干预下糖尿病肾病大鼠肾组织TLR4和PPARγ的相关性研究[J].中国免疫学杂志,2014,3(20):383-387.
[8] 姚建,陈名道.糖尿病肾病及其早期防治[J].中华内分泌代谢杂志,2002,18(4):330-331.
[9] 许曼英.糖尿病学[M].2版.上海:上海科学技术出版社,2010.
[10] 董元正,杨焕荣.雷公藤多苷对早期糖尿病肾病微炎症状态的干预研究[J].中国医药导报,2016,13(30):16-19.
[11] Ikenaga H,Suzuki H,Ishii N,et al. Enzymuria in non-insulin-dependent diabetic patients:signs of tubular cell dysfunction [J]. Clin Sci(Lond),1993,84(4):469-475.
[12] Ye H,Bai X,Gao H,et al. Urinary podocalyxin positive-element occurs in the early stage of diabetic nephropathy and is correlated with a clinical diagnosis of diabetic nephropathy [J]. J Diabetes Complications,2014,28(1):96-100.
[13] 徐艳,黄莉吉,余江毅.糖尿病肾病氧化应激相关观察指标的研究进展[J].医学综述,2013,19(9):1633-1635.
[14] Arechavaleta R,Seck T,Chen Y,et al. Efficacy and safety of treatment with sitagilptin or glimepiride in patients with type 2 diabetes inadequately controlled on metformin monotherapy:a randomized,double-blind,non-inferiority trial [J]. Diabetes Obes Metab,2011,13(2):160-168.
[15] Toblli JE,Ferrini MG,Cao G,et al. Antifibrotic effects of pioglitazone on the kidney in a rat model of type 2 diabetes mellitus [J]. Nephrol Dial Transplant,2009,28(8):2384-2391.
[16] 汪珊珊,陈冬,陈明卫,等.代谢综合征对2型糖尿病患者糖尿病肾病的影响分析[J].中国慢性病预防与控制,2011,19(5):509-511.
[17] Yang HC,Deleuze S,Zuo Y,et al. The PPARgamma agonist ameliorates aging-related progressive renal injury [J]. J Am Soc Nephrol,2009,20(11):2380-2388.
[18] 王俊英.前列地尔联合厄贝沙坦治疗早期糖尿病肾病的临床效果分析[J].中国现代医生,2015,53(12):81-83.
[19] 廖淑金,杨川,江慧琦,等.前列地尔治疗高龄糖尿病并慢性肾脏病患者疗效和安全性[J].中山大学学报,2015, 36(1):120-125.
[20] 伏杭江,杜方翀,胡燕,等.前列地尔治疗对2型糖尿病肾病患者氧化应激损伤的影响[J].医学研究生学报,2013, 26(8):801-803.