摘要【目的】探讨左卡尼汀联合前列地尔治疗对糖尿病肾病(DN)患者肾功能、氧化应激及炎症反应的影响。【方法】选取2019年3月到2021年3月在榆林市第五医学院诊治的98例DN患者,按照随机数字表法分为观察组和对照组,每组49例。对照组给予前列地尔治疗,观察组在对照组基础上加用左卡尼汀治疗,连续治疗4周,比较两组临床疗效、肾功能指标[尿素氮(BUN)、胱抑素-C(Cys-C)、24 h 尿蛋白(24hUpro)、β2微球蛋白(β2-MG)]、氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)、活性氧类物质(ROS)]、炎症因子[C-反应蛋白(CRP)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-17(IL-17)]水平及不良反应发生率。【结果】观察组患者总有效率为93.88%,显著高于对照组的77.55%,其差异有统计学意义(P<0.05)。治疗后,观察组患者BUN、Cys-C、24hUpro、β2-MG、MDA、ROS、CRP、IL-1β、IL-6水平显著低于对照组,SOD显著高于观察组,其差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】左卡尼汀联合前列地尔治疗DN,可提高患者临床疗效,改善患者肾功能、氧化应激及炎症反应,且具有较高的安全性。
Abstract：【Objective】 To investigate the effects of levocarnitine combined with alprostadil on renal function,oxidative stress and inflammation in patients with diabetic nephropathy (DN). 【Methods】 A total of 98 DN patients treated in Yulin Fifth Medical College from March 2019 to March 2021 were selected and divided into the observation group and the control group according to random number table method,with 49 cases in each group. The control group was treated with alprostadil,and the observation group was treated with L-carnitine on the basis of the control group,for consecutive 4 weeks. Clinical efficacy,renal function indexes [BUN,CYstatin C,24 h urinary protein,β2 microglobulin,24hUpro,β2-MG],oxidative stress indexes [MALondialdehyde (MDA),superoxide dismutase (SOD),reactive oxygen species (ROS)] and inflammatory factors [C-reactive protein (CRP), interleukin-1 β (IL-1β), interleukin-6 (IL-6), interleukin-17 (IL-17)] levels and the incidence of adverse reactions were compared between two groups. 【Results】 The total effective rate of observation group was 93.88%, which was significantly higher than that of control group (77.55%), and the difference was statistically significant (P<0.05). After treatment, the levels of BUN, CYS-C, 24hUpro, β2-MG, MDA, ROS, CRP, IL-1β and IL-6 in the observation group were significantly lower than those in the control group, while SOD was significantly higher than that in the observation group; The differences were statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】 Levocarnitine combined with alprostadil in the treatment of DN can improve the clinical curative effect, reduce the damage to the kidney, reducing oxidative stress and inflammation index.
姬冬林, 张亚琼. 左卡尼汀联合前列地尔治疗对糖尿病肾病患者肾功能、氧化应激及炎症反应的影响[J]. 医学临床研究, 2022, 39(5): 644-647.
JI Dong-lin, ZHANG Ya-qiong. Effects of Levocarnitine Combined with Alprostadil on Renal Function,Oxidative Stress and Inflammatory Response in Diabetic Nephropathy Patients. JOURNAL OF CLINICAL RESEARCH, 2022, 39(5): 644-647.
2022, Vol. 39 
