摘要
目的探讨醋酸波尼松联合来氟米特对免疫球蛋白A(IgA)肾病患者肾功能及血清肌酐(Scr)、尿素氮(BUN)水平的影响。方法抽取2013年11月至2018年11月驻马店市中心医院收治的64例IgA肾病患者为研究对象,按照随机数字表法将其分为对照组与观察组,每组32例。对照组患者给予醋酸泼尼松治疗,观察组患者在对照组基础上联合使用来氟米特治疗,两组患者均治疗6个月。比较两组临床疗效,观察治疗前及治疗后6个月两组患者肾功能[人血清白蛋白(Alb)、Scr、BUN、胱抑素C(CysC)]水平、24 h尿蛋白定量及血清转化生长因子-β1(TGF-β1)、细胞间黏附分子-1(ICAM-1)、单核细胞趋化蛋白-1(MCP-1),记录两组不良反应(转氨酶升高、恶心呕吐、肺部感染、乏力)发生情况。结果观察组临床总有效率(93.75%,30/32)高于对照组(75.00%,24/32),P<0.05。治疗后6个月,两组患者肾功能(Scr、BUN、CysC水平、24 h尿蛋白定量)及血清TGF-β1、ICAM-1、MCP-1水平均低于治疗前,且观察组低于对照组(P<0.05);两组患者Alb水平均高于治疗前,且观察组高于对照组(P<0.05)。两组患者不良反应发生率比较差异未见统计学意义(P>0.05)。结论醋酸波尼松联合来氟米特对IgA肾病患者疗效显著,能改善肾功能水平,且安全可靠。
Objective To investigate the effects of prednisone acetate combined with leflunomide on renal function and levels of serum creatinine (Scr) and blood urea nitrogen (BUN) in patients with immunoglobulin A (IgA) nephropathy.Methods Sixty-four patients with IgA nephropathy admitted to Zhumadian Central Hospital from November 2013 to November 2018 were selected as research subjects. According to the random number table method, patients were divided into observation group and control group, with 32 cases in each group. Patients in control group were treated with prednisone acetate, and patients in observation group were treated with leflunomide on the basis of treatment of control group. And the two groups were treated for 6 months. The clinical efficacy of the two groups was compared. The renal function, assessed by human serum albumin (Alb), Scr, BUN, Cystatin C (CysC), levels of 24 h urine protein quantitation and serum transforming growth factor-β1 (TGF-β1), intercellular adhesion molecule-1 (ICAM-1) and monocyte chemoattractant protein-1 (MCP-1) were observed in the two groups before treatment and 6 months after treatment. And the incidence of adverse reactions (transaminase elevation, nausea and vomiting, lung infection, fatigue) of the two groups were recorded.Results The total clinical effective rate in observation group (93.75%, 30/32) was significantly higher than that in control group (75.00%, 24/32), P<0.05. After 6 months of treatment, the levels of renal function indexes (Scr, BUN, CysC, 24 h urine protein quantitation) and serum TGF-β1, ICAM-1 and MCP-1 in the two groups were lower than those before treatment, and the levels of these indexes of observation group were lower than those of control group (P<0.05). After treatment, the Alb levels in the two groups were higher than those before treatment, and the level in observation group was higher than that in control group (P<0.05). There were no significant differences in the incidences of adverse reactions between the two groups (P>0.05).Conclusions Prednisone acetate combined with leflunomide has significant efficacy on patients with IgA nephropathy, and it can improve renal function, which is safe and reliable.
作者
郑建国
郑栓
王东海
Zheng Jianguo;Zheng Shuan;Wang Donghai(Department of Nephrology,Zhumadian Central Hospital,Zhumadian 463000,China)
出处
《中国实用医刊》
2020年第13期90-94,共5页
Chinese Journal of Practical Medicine
关键词
醋酸波尼松
来氟米特
IGA肾病
肾功能
Prednisone acetate
Leflunomide
Immunoglobulin A nephropathy
Renal function
