论文部分内容阅读
目的 :探讨早期糖尿病肾病(DN)患者应用醛糖还原酶抑制剂依帕司他(ARI)治疗后肾血流动力学参数的变化。方法:选择120例早期DN患者,分为对照组68例和治疗组52例,治疗组应用ARI治疗,对照组未应用ARI治疗,均治疗3个月。治疗前后应用彩色多普勒超声测定肾血流参数,测定生化指标,并比较2组治疗前后的临床指标及肾动脉血流动力学参数。结果:2组年龄、病程、空腹血糖、舒张压、收缩压、血清尿酸、低密度脂蛋白、三酰甘油、总胆固醇、高密度脂蛋白、腰围和体质量指数比较,差异均无统计学意义(均P>0.05)。治疗3个月后,治疗组肾动脉和肾段动脉舒张期末血流速度(EDV)均明显高于治疗前及对照组(均P<0.01);治疗组肾大叶间动脉收缩期峰值血流速度及EDV均明显高于治疗前及对照组(均P<0.01),血流RI显著低于治疗前及对照组(均P<0.01)。结论:ARI可改善早期DN的肾动脉血流,增加肾动脉灌注,改善肾小球微循环。
Objective: To investigate the changes of renal hemodynamic parameters in patients with early diabetic nephropathy (DN) treated with aldose reductase inhibitor epalrestat (ARI). Methods: A total of 120 patients with early DN were selected and divided into control group (n = 68) and treatment group (n = 52). The patients in the treatment group were treated with ARI and the control group without ARI. All patients were treated for 3 months. Before and after treatment, renal blood flow parameters were measured by color Doppler sonography, and the biochemical parameters were measured. The clinical parameters and the parameters of renal artery hemodynamics before and after treatment were compared. Results: There was no significant difference in age, course of disease, fasting blood glucose, diastolic blood pressure, systolic blood pressure, serum uric acid, low density lipoprotein, triglyceride, total cholesterol, high density lipoprotein, waist circumference and body mass index (All P> 0.05). At 3 months after treatment, EDV of the renal artery and renal arteries in the treatment group were significantly higher than those before treatment and in the control group (all P <0.01). In the treatment group, peak systolic blood flow Speed and EDV were significantly higher than before treatment and control group (all P <0.01), RI of blood flow was significantly lower than before treatment and control group (all P <0.01). Conclusion: ARI can improve renal artery blood flow in early DN, increase renal artery perfusion and improve glomerular microcirculation.