Short and long term therapeutic effects of prostaglandin El treatment on diabetic nephropathy / 中华老年医学杂志

ABSTRACT

Objective To investigate the short and long term therapeutic effects of prostaglandin E1 (PGEl) on diabetic nephropathy (DN). Methods Patients with DN in stage Ⅲ to Ⅴ according to Mogensen criteria were randomly assigned to four groups of PGE1, angiotensin-converting enzyme inhibitor (ACEI), PGE1 + ACEI and control drug. The levels of proteinuria and albuminuria were measured before and 15 days, 6 months and 18 months after treatment. Patients with DN in stage Ⅳ were subdivided into three groups according to proteinuria: early stage IV (protienuria was less than 1.5 g/d), middle stage Ⅳ (protienuria was between 1.5 g/d and 2.5 g/d) and late stage Ⅳ (protienuria was larger than 2.5 g/d). Results Fifteen days after treatment, the levels of proteinuria and albuminuria were significantly decreased compared with pre-treatment in PGE1 and PGE1 + ACEI groups (P<0. 01), and the therapeutic effect was better in PGE1 + ACE1 group than in ACEI group (P<0. 01). Six months after treatment, there were still significant differences in above parameters in patients with DN in stage Ⅲ and Ⅳ between PGE1 + ACEI and PGE1 groups. And for the patients in stage Ⅴ, statistic significance between pre-and post-treatment existed only in PGE1 + ACEI group (P<0. 05). but not in PGE1 and ACEI groups (both P>0. 05). Eighteen months atter treatment, the levels of proteinuria and albuminuria were significantly decreased in patients in stage HI and early stage IV in all treatment groups (P<0. 01). For patients in middle stage IV and late stage Ⅳ , the significant differences still occurred between pre-and post-treatment in PGE1 + ACEI group (P<0. 01 or P<0. 05), and were significantly better than in ACEI group (P<0. 01 or P<0. 05). However, the proteinuria of patients in late stage IV elevated in PGE1 group in post-treatment versus pre-treatment (P<0. 05). Conclusions The short term therapeutic effect of PGE1 is quick and good in patients with DN. The therapeutic effect is much better in patients in stage Ⅲ compared with stage Ⅴ. The combination of PGE1 and ACEI will get better best therapeutic effect than PGE1 or ACEI alone in long term.