目的 探討前列地爾聯(lián)合格列喹酮治療老年糖尿病腎病的臨床效果。方法 選取2013年9月-2016年3月內(nèi)蒙古醫(yī)科大學(xué)附屬醫(yī)院接收治療的糖尿病腎病患者80例，隨機分為對照組與治療組，每組各40例。對照組患者在常規(guī)治療的基礎(chǔ)上餐前半小時口服格列喹酮片30～60 mg/d，1次/d。治療組在對照組的基礎(chǔ)上靜脈滴注前列地爾注射液，10 μg加入到生理鹽水100 mL中，1次/d。兩組患者均連續(xù)治療4周。然后觀察兩組臨床療效，同時比較兩組患者空腹血糖（FBG）、餐后2 h血糖、尿蛋白排泄率（UPER）、血肌酐（Scr）、24 h尿蛋白（24 h Upro）和腎小球濾過率（eGCR）水平變化。結(jié)果 治療后，對照組和治療組的總有效率分別為82.5%和97.5%，兩組總有效率比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者FBG和餐后2 h的血糖水平均顯著降低（P<0.05）；且治療后治療組患者的血糖水平比對照組降低的更明顯（P<0.05）。治療后，兩組患者24 h Upro、Scr和UPER與治療前相比明顯降低，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療后治療組患者24 h Upro、Scr和UPER水平與對照組相比降低更明顯，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）；而治療前后兩組患者eGFR水平比較差異沒有統(tǒng)計學(xué)意義。結(jié)論 前列地爾聯(lián)合格列喹酮治療老年糖尿病腎病效果顯著，能夠有效改善患者的血糖及腎功能，具有一定的臨床推廣應(yīng)用價值。

Objective To observe the curative effect of alprostadil combined with gliquidone in treatment of elderly diabetic nephropathy. Methods Patients (80 cases) with diabetic nephropathy in the Affiliated Hospital of Inner Mongolia Medical University from September 2013 to March 2016 were randomly divided into the control and treatment groups, and each group had 40 cases. The patients in the control group were po administered with Gliquidone Tablets half an hour before meals based on the conventional therapy, 30-60 mg/d, once daily. The patients in the treatment group were iv administered with Alprostadil Injection on the basis of the control group, 10 μg added into normal saline 100 mL, once daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the change of FBG, 2 h postprandial glucose, UPER, Scr, 24 h Upro, and eGCR levels in two groups was compared. Results After treatment, the clinical efficacy in the control and treatment group was 82.5% and 97.5%, respectively, and there were differences between two groups (P<0.05). After treatment, FBG and 2 h postprandial glucose levels in two groups were significantly decreased (P<0.05). And FBG and 2 h postprandial glucose levels in the treatment group decreased more than those in the control group, with significant difference between two groups (P<0.05). After treatment, 24 h Upro, Scr, and UPER levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And 24 h Upro, Scr, and UPER levels in the treatment group decreased more than those in the control group, with significant difference between two groups (P<0.05). However, there was no significant difference in eGFR between two groups before and after treatment. Conclusion Alprostadil combined with gliquidone has a significant clinical effect in treatment of elderly diabetic nephropathy, can effectively improve the blood glucose and renal function, which has a certain clinical application value.