邱冬豪　赵宁　王鸣

[摘要] 目的 研究前列地尔合并肾康片对2型糖尿病肾病患者血清肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）及白介素-8（IL-8）水平的影响。 方法 选取2014年6月～2015年5月我院收治的62例2型糖尿病肾病患者，根据随机抽签法分为试验组与对照组，各31例。对照组使用20 mL的生理盐水和10 μg的前列地尔混合后，静脉推注的方式给药，1次/d。试验组在对照组治疗的基础上口服肾炎康复片，一次5片，一天3次。所有患者的治疗疗程均为4周。观察治疗前和治疗4周后的空腹血糖（FBG）、糖化血红蛋白（HbA1c）、TNF-α、IL-6及IL-8水平变化，评判两组患者的不良反应。 结果 治疗后，试验组的TNF-α、IL-6及IL-8水平显著低于对照组[（7.30±0.41）ng/L vs （9.44±1.78）ng/L，（9.39±0.31）ng/L vs （11.36±0.66）ng/L，（7.25±0.95）ng/L vs （11.35±1.07）ng/L]（P<0.05）。試验组的FBG、HbA1c水平显著低于对照组[（6.52±0.40）mmol/L vs （9.32±0.64）mmol/L，（6.53±0.60）% vs （7.44±0.68）%]（P<0.05）。试验组和对照组的不良反应率比较差异无统计学意义[12.90%（4/31） vs 16.13%（5/31）]（P>0.05）。结论 前列地尔合并肾康片能明显降低2型糖尿病肾病患者血清TNF-α、IL-6、IL-8、FBG、HbA1c水平，临床疗效良好，安全性高。

[关键词] 前列地尔；肾康片；2型糖尿病肾病；TNF-α；IL-6；IL-8

[中图分类号] R587.1 [文献标识码] A [文章编号] 1673-9701（2017）13-0034-04

[Abstract] Objective To explore the effects of alprostadil combined with Shenkang tablet on serum TNF-α， IL-6 and IL-8 levels in patients with type 2 diabetic nephropathy. Methods Sixty-two patients with type 2 diabetic nephropathy in our hospital from June 2014 to May 2015 were enrolled in the study. According to the randomized method， the patients were divided into experimental group（n=31） and control group（n=31）. The control group was treated with 20 mL of physiological saline and 10 μg of alprostadil intravenously once a day. The experimental group was given Shenkang tablets orally once five， three times a day based on the treatment of the control groups. All patients were treated for 4 weeks. The changes of fasting blood glucose （FBG）， glycosylated hemoglobin（HbA1c）， TNF-α， IL-6 and IL-8 levels before and 4 weeks after treatment were observed， and the adverse reactions of the two groups were evaluated. Results After treatment， the levels of TNF-α， IL-6 and IL-8 in the experimental group[（7.30±0.41） ng/L， （9.39±0.31）ng/L， 7.25±0.95）ng/L] were significantly lower than those in the control group [（9.44±1.78）ng/L， （11.36±0.66） ng/L， （11.35±1.07） ng/L）]（P<0.05）.The levels of FBG and HbA1c in the experimental group[（6.52±0.40） mmol/L， （6.53±0.60）%] were significantly lower than those in the control group[（9.32±0.64） mmol/L， （7.44±0.68）%] （P<0.05）. There was no significant difference in the adverse reaction rate between the experimental group and the control group[12.90%（4/31） vs 16.13% （5/31）] （P>0.05）. Conclusion Prostaglandil combined with Shenkang tablet can significantly reduce the levels of serum TNF-α， IL-6， IL-8， FBG and HbA1c in patients with type 2 diabetic nephropathy. The clinical efficacy is good and the safety is high.

[Key words] Alprostadil； Shenkang tablet； Type 2 diabetic nephropathy； TNF-α； IL-6； IL-8

2型糖尿病肾病属于糖尿病较为常见的一种并发症，也是导致糖尿病患者死亡的主要因素。在治疗糖尿病肾病中降糖药物的选取尤为关键，其所引发的低血糖等不良反应，有利于降低血糖水平[1]。前列地尔在改善微循环中具有较好的效果，但其曾使用粉针制剂常常伴有静脉炎等不良反应，前列地尔在脂微球包裹后，能大幅度降低药物所产生的不良反应，并且还能加强药物在血管病变部位中的浓度[2-3]。为探讨如何有效的治疗2型糖尿病肾病，本研究就前列地尔合并肾康片对2型糖尿病肾病患者血清肿瘤坏死因子-α（Tumor necrosis factor alpha，TNF-α）、白介素-6（Interleukin-6，IL-6）及白介素-8（Interleukin-8，IL-8）和水平的影响进行分析，现报道如下。……