2021 年第 5 期 第 16 卷

前列地尔联合尿毒清颗粒治疗老年慢性肾功能不全的效果及安全性分析

Effect and safety of alprostadil combined with Niaoduqing granules on chronic renal insufficiency in the elderly

作者：吴岳春1 黄庆龙1 杨明榴1 潘沁1 杨绪枫2

英文作者：Wu Yuechun1 Huang Qinglong1 Yang Mingliu1 Pan Qin1 Yang Xufeng2

单位：1安徽省池州市人民医院肾脏内科247000；2江苏省苏州市第九人民医院老年医学科215200

英文单位：1Demartment of Nephrology the People′s Hospital of Chizhou Anhui Province Chizhou 247000 China; 2Department of Geriatrics Suzhou Ninth People′s Hospital Jiangsu Province Suzhou 215200 China

关键词：慢性肾功能不全；前列地尔；尿毒清颗粒；炎性因子；免疫功能

英文关键词：Chronicrenalinsufficiency;Alprostadil;Niaoduqinggranules;Inflammatoryfactors;Immunefunction

• 摘要：

• 目的 探究前列地尔联合尿毒清颗粒治疗老年慢性肾功能不全的效果，并对其安全性进行分析。方法 选取2017年8月至2019年8月安徽省池州市人民医院收治的老年慢性肾功能不全患者96例，随机数字表法分为观察组和对照组，各48例。对照组在常规治疗基础上给予前列地尔静脉滴注，观察组在对照组基础上予尿毒清颗粒口服，2组均连续治疗2周。比较2组患者的临床疗效及治疗前后肾功能指标、炎性因子和免疫功能指标水平。结果 观察组总有效率高于对照组［91.7%（44/48）比75.0%（36/48）］（χ2=4.800，P=0.028）。治疗后，2组估算肾小球滤过率均高于治疗前，且观察组高于对照组［（81±13）ml/(min·1.73 m2)比（73±11）ml/(min·1.73 m2)］，血肌酐、血尿素氮和血尿酸水平均低于治疗前，且观察组低于对照组［（160±18）μmol/L比（172±17）μmol/L、（9.6±1.9）mmol/L比（10.4±1.7）mmol/L、（423±23）μmol/L比（449±21）μmol/L］，差异均有统计学意义（均P＜0.05）。治疗后，2组白细胞介素6、血清肿瘤坏死因子α和高敏C反应蛋白水平均低于治疗前，且观察组均低于对照组（均P＜0.05）。治疗后，2组免疫球蛋白（Ig）G、IgM、IgA和尿补体C3水平均高于治疗前，且观察组高于对照组，差异均有统计学意义（均P＜0.05）。结论 前列地尔联合尿毒清颗粒在治疗老年慢性肾功能不全方面效果确切，能有效改善患者的临床症状、降低炎性因子的表达水平、提高肾功能和免疫功能。

• Objective To investigate the effect of alprostadil combined with Niaoduqing granules on chronic renal insufficiency in the elderly, and to analyze its safety. Methods From August 2017 to August 2019, 96 elderly patients with chronic renal insufficiency admitted to the People′s Hospital of Chizhou, Anhui Province were selected. They were randomly divided into observation group and control group, with 48 cases in each group. The control group was given alprostadil intravenous drip on the basis of conventional treatment, and the observation group was treated with Niaoduqing granules orally on the basis of the control group. Both groups were treated for 2 weeks. The clinical effect, renal function indexes, inflammatory factors and immune function indexes levels were compared between the two groups before and after treatment. Results The total effective rate of treatment in the observation group was higher than that in the control group ［91.7%（44/48） vs 75.0%（36/48）］(χ2=4.800, P=0.028). After treatment, the estimated gomemlar filtration rates in both groups were higher than those before treatment, and that in the observation group was higher than that in the control group［（81±13）ml/(min·1.73 m2) vs （73±11）ml/(min·1.73 m2)］; the levels of serum creatinine, blood urea nitrogen and blood uric acid in both groups were lower than those before treatment, and those in the observation group were lower than those in the control group ［(160±18)μmol/L vs (172±17)μmol/L,( 9.6±1.9)mmol/L vs (10.4±1.7)mmol/L,(423±23)μmol/L vs (449±21)μmol/L］(all P<0.05). After treatment, the levels of interleukin-6, serum tumor necrosis factor-α and high-sensitivity C-reactive protein in both groups were lower than those before treatment, and those in the observation group were lower than those in the control group (all P<0.05). After treatment, the levels of immunoglobulin (Ig) G, IgM, IgA and urine complement C3 in both groups were higher than those before treatment, and those in the observation group were higher than those in the control group (all P<0.05). Conclusions Alprostadil combined with Niaoduqing granules is effective in the treatment of chronic renal insufficiency in the elderly patients. It can effectively improve the patients′clinical symptoms, reduce the expression levels of inflammatory factors, and improve the renal function and immune function.