EndoPAT2000评估丹红注射液联合脑心通胶囊干预高龄患者糖尿病肾病早期病变血管内皮功能的临床研究

摘要

Objective To observe the amelioration of vascular endothelial function by applying noninvasive vascular endothelial diagnosis system (EndoPAT2000) in elderly patients with early lesion of diabetic nephropathy (DN) after intervention of Danhong Injection combined with Naoxintong Capsules.Methods The patients (age>75, n=92) were chosen from the Fourth Department of Geriatrics,Chinese PLA Army General Hospital from Jan. 2014 to Jan. 2017,and then divided randomly into observation group and control group (n=46) on the base of controlling blood sugar level. The control group was treated continuously with perindopril for 6 months,and observation group was treated with Danhong Injection, Naoxintong Capsules and perindopril for 2 weeks and then with Naoxintong Capsules and perindopril for 6 months. The changes of 24-h quantification of urine protein (UP) and vascular endothelial function were compared in 2 groups after treatment.Results The total effective rate was 82.61% in observation group, which was significantly higher than that in control group (56.52%). The Endo-PAT index (RHI) was significantly improved in 2 groups (P<0.05),and improvement of vascular endothelial function was significantly superior in observation group to that in control group.Conclusion The indexes of vascular endothelial function are significantly lower than normal value in patients with early lesion of DN,and Danhong Injection combined with Naoxintong Capsules can improve the therapeutic efficacy and vascular endothelial function. EndoPAT2000 can be taken as a practical indicator to review the treatment of early lesion of DN.%目的 通过采用无创血管内皮诊断系统EndoPAT2000,观测高龄患者糖尿病肾病(DN)早期病变经丹红注射液联合脑心通胶囊干预后,对血管内皮功能的改善情况.方法 选取2014年1月~2017年1月于陆军总医院干四科就诊的75岁以上,符合糖尿病肾病早期病变患者92例,在控制血糖的基础上将其随机分为糖尿病肾病早期病变观察组和对照组两组,每组各46例.对照组持续使用培哚普利治疗6个月,观察组用丹红注射液+脑心通胶囊联合培哚普利干预,2周后继续使用脑心通胶囊联合培哚普利治疗至6个月.治疗结束后比较两组患者治疗前后24 h尿蛋白定量、血管内皮功能变化.结果 观察组联合治疗总有效率为82.61%,显著高于对照组的56.52%.两组RHI值均明显提高(P<0.05),观察组血管内皮功能改善情况明显优于对照组.结论 糖尿病肾病早期病变患者的血管内皮功能明显低于正常值,经丹红注射液联合脑心通胶囊可明显提高早期病变的治疗有效率,改善内皮功能,血管内皮功能诊断系统EndoPAT2000可作为评估高龄患者糖尿病肾病早期病变治疗情况的实用指标.