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前列地尔联合杏丁注射液治疗慢性肾衰竭的效果及对Hcy、FGF-23水平的影响
作者:沈杰1 2  叶朝阳2 
单位:1. 上海市杨浦区中心医院 肾脏内科, 上海 200090;
2. 海军军医大学附属长征医院 肾内科, 上海 200003
关键词:前列地尔 杏丁注射液 慢性肾衰竭 同型半胱氨酸 成纤维细胞生长因子 
分类号:R586.9
出版年·卷·期(页码):2019·47·第一期(45-49)
摘要:

目的:研究前列地尔联合杏丁注射液治疗慢性肾衰竭的效果及其对同型半胱氨酸(Hcy)、人成纤维细胞生长因子23(FGF-23)水平的影响。方法:以76例慢性肾衰竭住院患者为研究对象,随机分为对照组和观察组,每组38例。观察组采用前列地尔联合杏丁注射液治疗,对照组仅采用前列地尔治疗。两组患者均用药14d。比较两组的疗效,患者肾功能,血清Hcy、FGF-23水平以及不良反应之间的差异。结果:治疗后,观察组总有效率(78.94%)明显高于对照组(57.89%),差异有统计学意义(χ2=3.901,P=0.048)。治疗前两组患者肾功能指标比较,差异无统计学意义(P>0.05);治疗后两组24 h尿蛋白量、血尿素氮、血尿酸、血清肌酐水平均降低(P<0.05)。观察组比对照组降低更显著(P<0.05);两组患者肌酐清除率均升高(P<0.05),观察组比对照组升高更显著(P<0.05);观察组治疗后Hcy及FGF-23水平均显著低于对照组,差异有统计学意义(P<0.05)。两组之间不良反应发生情况比较,差异无统计学意义。结论:前列地尔联合杏丁注射液治疗慢性肾衰竭患者效果明显,其通过下调体内Hcy、FGF-23水平发挥抗氧化、清除自由基、调节肾功能的作用,安全性较好,值得在临床中使用。

Objective:To investigate the efficacy of alprostadil combined with xingding injection in the treatment of chronic renal failure and its effect on the levels of homocysteine (Hcy) and human fibroblast growth factor 23 (FGF-23).Methods: Seventy-six hospitalized patients with chronic renal failure were enrolled in this study and were randomly divided into control group and observation group, 38 cases in each group. The observation group was treated with alprostadil combined with Xingding injection, while the control group was only treated with alprostadil. All the patients were treated for 14 days, and the differences of efficacy, renal function, the levels of serum Hcy and FGF-23,adverse reactions between the two groups were compared. Results: After treatment, the total effective rate of the observation group (78.94%) was significantly higher than that of the control group (57.89%), and the difference was statistically significant (χ2=3.901,P=0.048). There was no statistically significant difference in renal function indexes between the two groups before treatment (P>0.05).After treatment, the 24 h urinary protein level, blood urea nitrogen, blood uric acidand serum creatininelevel in the two groups were all decreased (P<0.05), and the decrease was more significant in the observation group (P<0.05).Creatinine clearance ratewas increased in the both groups (P<0.05), and the increase was more significant in the observation group (P<0.05).After treatment, the levels of Hcy and FGF-23 in the observation group were significantly lower than those in the control group (P<0.05).There was no statistically significant difference in adverse reactions between the two groups.Conclusion: Alprostadil combination with Xingding injection in the treatment of patients with chronic renal failure has obvious effects. By down-regulating the Hcy and FGF-23 levels in the body, it exerts antioxidant activity, scavenges free radicals and regulates renal function with better safety, which is worthy of clinical use.

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