摘要
目的探讨雷公藤多苷联合贝那普利在老年原发性肾病综合征(primary nephrotic syndrome,PNS)治疗中的作用。方法选取2016年2月至2018年3月洛阳市第一人民医院88例老年PNS病人,采用随机数字表法分为观察组与对照组,每组44例。常规饮食及治疗基础上,对照组给予贝那普利治疗,观察组给予贝那普利+雷公藤多苷治疗,两组均连续治疗12周。对比两组临床疗效、治疗前后肾功能指标[血清尿素氮(BUN)、血清肌酐(Scr)、24 h尿蛋白定量]、血清免疫球蛋白(IgA、IgM、IgG)水平、血清糖类抗原(CA15⁃3、CA19⁃9、CA125)水平、生活质量(KDQOL⁃SF评分)改善情况及治疗期间不良反应发生率。结果观察组治疗总有效率90.91%(40/44)高于对照组75.00%(33/44),差异有统计学意义(P<0.05);治疗后两组血清BUN、Scr水平及24 h尿蛋白定量低于对照组,差异有统计学意义(P<0.05);治疗后观察组血清IgA(2.91±1.01)g/L、IgG(9.81±1.43)g/L高于对照组[(2.47±0.92)g/L、(7.72±1.58)g/L],IgM(0.86±0.41)g/L低于对照组(1.07±0.52)g/L,差异有统计学意义(P<0.05);治疗后观察组血清CA15⁃3、CA19⁃9、CA125水平低于对照组,差异有统计学意义(P<0.05);治疗后两组KDQOL⁃SF评分较治疗前有所提高,差异有统计学意义(P<0.05),且观察组高于对照组,差异有统计学意义(P<0.05);治疗期间,观察组头晕/头痛、咳嗽、嗜睡、恶心/呕吐等不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。结论给予老年PNS病人雷公藤多苷与贝那普利联合治疗,效果显著,有利于改善病人肾功能,可能与其对血清免疫球蛋白水平的调节作用有关,且该方案可下调血清CA15⁃3等糖类抗原表达,促进病人生活质量提高,安全性亦有保证。
Objective To investigate the role of Tripterygium glycosides combined with benazepril in the treatment of elderly pa⁃tients with primary nephrotic syndrome(PNS).Methods Eighty⁃eight elderly patients with PNS admitted to the First People’s Hospital of Luoyang from February 2016 to March 2018 were enrolled.The patients were divided into observation group and control group according to the random number table method,with 44 cases in each group.On the basis of conventional diet and treatment,the control group was treated with benazepril,and the observation group was treated with benazepril+Tripterygium glycosides.The two groups were treated continuously for 12 weeks.Compare the clinical efficacy of the two groups,renal function indicators before and after treatment[serum urea nitrogen(BUN),serum creatinine(Scr),24 h urine protein quantitation],serum immunoglobulin(IgA,IgM,IgG)levels,serum carbohydrate antigens(CA15⁃3,CA19⁃9,CA125)levels,quality of life(KDQOL⁃SF score)improve⁃ment and incidence of adverse reactions during treatment.Results(1)The total effective rate of the observation group was 90.91%(40/44),higher than that of the control group 75.00%(33/44)(P<0.05);(2)Renal function:serum BUN after treatment,the lev⁃els of Scr and 24 h urine protein were lower than those in the control group(P<0.05)(.3)After treatment with serum immunoglob⁃ulin,serum IgA and IgG were higher in the observation group than those in the control group,and IgM was lower than that in the control group(P<0.05)(.4)Serum carbohydrate antigen level:serum CA15⁃3,CA19⁃9,CA125 levels in the observation group were lower than those in the control group after treatment(P<0.05);(5)Quality of life:After treatment,the KDQOL⁃SF scores of the two groups were higher than those before treatment(P<0.05),and the observation group was higher than the control group(P<0.05);(6)Safety:during the treatment period,the incidence of adverse reactions such as dizziness/headache,cough,lethargy,nausea/vomiting in the observation group and the control group There was no significant difference between the groups(P>0.05).Conclusions The combination of Tripterygium glycosides and benazepril in elderly patients with PNS has a significant effect,which is beneficial to improve renal function in patients.It may be related to the regulation of serum immunoglobulin levels.Moreover,the regimen can down⁃regulate the expression of carbohydrate antigens such as serum CA15⁃3,promotes the improvement of patients’quality of life and ensure the safety.
作者
朱俊利
毛永炎
ZHU Junli;MAO Yongyan(Department of Nephrology,the First People’s Hospital of Luoyang,Luoyang,Henan 471000,China;Department of Nephrology,the third People’s Hospital of Luoyang,Luoyan,Henan 471000,China)
出处
《安徽医药》
CAS
2020年第1期179-183,共5页
Anhui Medical and Pharmaceutical Journal
