Clinica Study L Of Combination Thetapy With Prostaglanding E1 And Angiotensin-Converting Enzyme Inhibitor In Patients Of Diabetic Nephropathy

Objectives:To investigate the thrapeutic effects of combination therapy with prostaglandin E1 (PGE1) and angiotensin-converting enzyme inhibitor on diabetic nephropathy(DN) after one year.Methods Patients with DN stageâ…¢, stageâ…£and stageâ…¤were divided according to Mogensen diabetic nephropathy diagnostic criteria. Patients with stageâ…£nephropathy were subdivided into three groups according to their amounts of proteinuria excreted:early stageâ…£(the amount of protienuria excreted was less than 1.5g/d), middle stageâ…£(the amount of protienuria was between 1.5g/d and 2.5g/d) and late stageâ…£(the amount of protienuria reached above 2.5g/d). They were randomly received PGE1 (PGE1 group), PGE1 plus angiotensin-converting enzyme inhibitor (ACEI, PGE1+ACEI group), ACEI mono-therapy (ACEI group) and control (control group). Proteinuria and albuminuria were measured before and after treatment for 15 days and 1 year.Results:(1) In the patients with DN stageâ…¢and early stageâ…£, and their proteinuria and albuminuria descended significantly in PGEl+ACEI and PGE1 group after 15 days and 1 year compared with that pre-treatment(P<0.01) and the amplitudes descended were larger than that of ACEI group(P<0.01 or P<0.05). (2) In the patients with middle stage and late stageâ…£nephropathy, the proteinuria and albuminuria decreased significantly in PGEl+ACEI group afterl5 days and 1 year compared with that pre-treatment (P<0.01) and the decreasing amplitude were larger than that of ACEI group (P<0.01). These two indicators descended significantly in PGEl group afterl5 days compared with that pre-treatment (P<0.01) but were higher than that of ACEI group one year later (P<0.05). (3) In the patients with stage V nephropathy, the proteinuria and albuminuria descended significantly in PGE1+ACEI and PGEl group afterl5 days compared with that pre-treatment (P<0.01) and the decreasing amplitude were larger than that of ACEI group (P<0.01 or P<0.05). These two indicators in PGE1+ACEI group had no statistical difference compared with that pre-treatment but were lower than that of ACEI group (P< 0.05) one year later,while they were higher than that pre-treatment(P<0.05) in ACEI and PGEl group.Conclusions:The therapeutic effects are much better in patients with stageâ…¢nephropathy in comparation with stageâ…¤. The combination of PGE1 and ACEI will get the best therapeutic effects and is more effective than PGE1 or ACEI alone even when following up to 1 year.