| Objective: To study the clinical effectiveness of Alprostadil Injection in the treatment of benign arteriolar nephrosclerosis caused by the elderly hypertension; to observe its effect on kidney protection;to observe its Safety on the treatment.Methods: From November 2013 to November 2014, 100 cases with benign arteriolar nephrosclerosis caused by primary elderly hypertension, in the geriatrics department of Chengde Central Hospital, have been selected and randomly divided into an experimental group and a control group. All patients met the diagnostic criteria of benign arteriolar nephrosclerosis:①All patients met the diagnosis of primary hypertension standard. ② The hypertension course generally greater than 10 years.③Routine urine suggested the mild to moderate proteinuria and fewer urine visible components in the microscopic examination.④Often accompanied by retinal arteriosclerosis change.⑤To get rid of primary and secondary renal diseases. All patients meet diagnostic criteria of hypertension promulgated by the China Hypertension League and the National Cardiovascular Center in 2010. It is based on the《Guidelines for prevention and treatment of hypertension Chinese 2010》. All patients met the diagnostic criteria of the elderly in China: more than 60 years old. Before selection, the excluded diseases are secondary hypertension, primary kidney disease, secondary kidney disease, serious heart failure, glaucoma, gastric ulcer, hemorrhage of digestive tract, interstitial pneumonia, diabetic nephropathy, the alprostadil allergic history, the fatal diseases such as malignant tumor etc. To except the Withdrawal patients in halfway and patients without the requirements of experiment;To except the renal failure patients because of infection or other factors in the course of treatment. The all patients are given the conventional treatment of blood pressure control. Firstly, all patients are given lifestyle interventions: weight control, reasonable exercise, the small amount of alcohol, to give up smoking, the good state of mind. The first choice in medicine is ACEI such as enalapril, The second choice is ARB such as irbesartan when ACEI lead to adverse reactions. They can choose CCB such as amlodipine or Beta blockers such as bisoprolol when they want. They need avoid the use of diuretics, so as not to interfere with the observation index. The experimental group, on the basis of routine treatment, is given intravenous infusion of 50 ml Sodium Chloride Injection(0.9%) and 10 ug Alprostadil Injection, once during the daily treatment. After 14 days’ treatment, the curative effect is judged and proved.Results: There were no significant statistical differences between two groups of patients with indexes. They were comparable(P>0.05). These indexes are the proportion of sex, age, smoking history, drinking history, blood pressure levels before treatment, renal function(including urea nitrogen, creatinine, uric acid), 24 hour urinary protein, urinary albumin excretion rate. All the selected patients have experienced 14 days’ treatment. The total effective rate is 96% in the experimental group, significantly higher than the control group(52%, P<0.05). The outcomes of renal function in the two groups, including blood urea nitrogen, blood creatinine, blood uric acid level, 24 hours urinary protein quantity and urinary micro albumin excretion rate level, have declined. These indexes in the experimental group after treatment(blood urea nitrogen, blood creatinine, blood uric acid level, 24 hour urinary protein and urinary albumin excretion rate) are significantly lower than the control group. The conclusion had a statistical significance(P<0.05), Before and after treatment, there is no significant difference between the two groups of patients with blood pressure levels. After treatment, the blood pressure of two groups have reached the standard, both below 130/80 mm Hg. Meanwhile, during the process of treatment, some adverse reactions have not been found in the experimental group and the control group. There are two patients with Symptoms of skin redness and pain in experimental group during treatment,but patients can be tolerated, the treatment process is not affected. Abnormal changes of liver function, blood routine were not found after treatmentafter.Conclusions: Alprostadil injection can be used for the treatment of benign arteriolar nephrosclerosis caused by elderly hypertension, and can improve patients with kidney damage, protecting renal function. Its curative effectiveness is obvious, has little side effect and is worth promoting. |
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