内科

目的观察前列地尔联合α硫辛酸（alpha-lipoic acid，ALA）治疗早期糖尿病肾病（DN）的疗效。方法选择确诊为早期DN患者120例随机分为三组，每组40例。联合组患者给予前列地尔10 μg静脉滴注，1次/d；α硫辛酸600 mg静脉滴注，1次/d。前列地尔组患者给予前列地尔10 μg静脉滴注，1次/d。ALA组给予α硫辛酸600 mg静脉滴注，1次/d。3周为1个疗程。治疗期间监测患者血糖，观察有无皮下淤青，3周后测定患者血肌酐（Cr）及24 h尿微量蛋白排泄率（UAER），并行眼底检查了解有无眼底事件的发生。结果治疗前后三组患者血糖、Cr无明显变化，联合组患者24 h UAER降低明显优于前列地尔组及ALA组患者（P＜0.05），三组患者皮下淤青及眼底事件发生率比较差异无统计学意义（P＞0.05）。结论前列地尔联合ALA治疗早期DN疗效及安全性均较好。

ObjectiveTo observe the effect of alprostadil combined with alpha-lipoic acid (ALA) in treatment of early diabetic nephropathy. Methods120 patients with early diabetic nephropathy were randomly divided into three groups, 40 cases in each. The combination therapy group was treated with alprostadil,10 μg per day,intravenous drip; plus alpha-lipoic acid 600mg per day,intravenous drip. The alprostadil group was treated with alprostadil,10 μg per day, intravenous drip; and the ALA group was treated with alpha-lipoic acid, 600 mg per day, intravenous drip. The blood glucose and subcutaneous bruises of all the patients were observed during the 3-weeks duration of treatment. Cr and the 24h urine albumin excretion rate (UAER) were measured, and ophthalmic fundus examination was performed following the treatments. ResultsAfter treatment, there were no significant differences in the blood glucose and Cr levels among the 3 groups compare to before treatment(P＞0.05), while the 24h UAER of the combination therapy group was obviously lower than that of any other group (P＜0.05). There were no significant differences in the incidence of subcutaneous bruises and ophthalmic fundus adverse events among the 3 groups (P＞0.05). ConclusionsAlprostadil combined with alpha-lipoic acid is an effective and safe therapy for patients with early diabetic nephropathy.