目的比较前列腺素E1(PGE1)20μg/d与10μg/d降低糖尿病肾病尿微量白蛋白的疗效。方法选择尿微量白蛋白在200~300 mg/d、血糖控制良好、无高血压的2型糖尿病肾病患者360例,随机分为3组:10μg组、20μg组和贝那普利组,每组120例,分别给予PGE1 10μg/d、20μg/d和贝那普利10 mg/d治疗,与治疗前、治疗后15 d、6个月、12个月分别检测尿微量白蛋白。结果 (1)治疗后15 d时,10μg组和20μg组尿微量白蛋白较治疗前明显下降(P0.01),而贝那普利组未见显著下降(P0.05)。20μg组和10μg组与贝那普利组比较差异有统计学意义(P0.01),但20μg组与10μg组比较,差异无统计学意义(P0.05)。(2)治疗后6个月,3组的尿白蛋白与治疗前比较均显著下降(P0.01),三组间疗效无统计学差异(P0.05)。(3)治疗后12个月,与治疗前比较,3组的尿白蛋白均显著下降(P0.05),贝那普利组的疗效较10μg组和20μg组更显著,差异有统计学意义(P0.01);20μg组与10μg组比较无统计学差异(P0.05)。结论在治疗后15 d、6个月、12个月时PGE1 20μg和10μg均能显著地降低尿白蛋白,但20μg和10μg间未见统计学差异;PGE1起效快,治疗后15 d时,2组PGE1的疗效显著优于贝那普利,6个月时与贝那普利类似,12个月时显著劣于贝那普利。
Objective To investigate the efficacy of 20μg prostaglandin E1 compared with 10μg on diabetes kidney disease. Methods Type 2 diabetes with albuminemia were enrolled and randomly divided into three groups and received prostaglandin E1 10μg, 20μg and lotensin 10 mg daily respectively. Urine albumin was collected after 15 days, 6 months and 12 months. Results Urine albumin was significantly decreased in 20 μg and 10 μg groups and not in lotensin group after 15 days of treatment. Urine albumin was significantly decreased in all 3 groups at the 6 months and 12 months of treatment. However, there was no significant difference on albumin decline between PGE1 20μg and 10μg groups at 15 days, 6 months and 12 months. Conclusion Lotensin and both PGE1 10 μg and 20 μg can decrease urine albumin significantly. However, there was no significant difference on albumin decline between PGE1 20μg and 10μg groups.