摘要
目的探讨泼尼松联合环磷酰胺(CTX)治疗原发性免疫球蛋白A(IgA)肾病患者的疗效及对肾功能指标的影响。方法选取本院2013年6月至2015年6月收治的86例IgA肾病患者为研究对象,根据随机数字表将患者分为观察组及对照组各43例。对照组给予泼尼松治疗,观察组在对照组基础上应用CTX治疗,两组均持续治疗12周,对比分析两组患者治疗疗效、肾功能指标的变化。结果观察组总有效率为97.67%,对照组总有效率为79.07%,差异有统计学意义(P<0.05)。观察组治疗后尿素氮(BUN)、血清肌酐(Scr),24h尿蛋白分别为(4.33±1.24)mmol/L、(85.36±5.85)mol/L、(1.89±0.24)g低于对照组[(6.32±2.02)mmol/L、(158.25±8.36)mol/L、(4.22±0.32)g],差异均有统计学意义(P<0.05),而内生肌酐清除率(Ccr)(85.98±14.02)高于对照组(68.23±12.02),差异有统计学意义(P<0.05)。观察组治疗后肾血管指数、肾小球指数、肾小管-间质指数积分及新月体指数分别为(2.12±0.96)分、(2.12±0.88)分、(2.02±0.85)分及0.22±0.08,均低于对照组[(3.02±0.85)分、(3.85±1.22)分、(3.12±0.96)分及0.48±0.10)],差异有统计学意义(P<0.05)。两组患者不良反应率比较差异无统计学意义(P>0.05)。结论泼尼松联合CTX可提高IgA肾病患者临床治疗效果,改善患者肾功能,且不良反应率低,安全有效,值得临床推广应用。
Objective To investigate the effect of prednison combined with cytoxan（CTX）on the efficacy and renal function parameters in patients with immunoglobulin A（IgA）nephropathy.Methods A total of 86 cases with IgA nephropathy patients were divided into observation group（n=43）and control group（n=43）from June 2013 to June 2015.The control group groups were treated with prednison,while the observation groups were given the treatment of prednison combined with CTX,and both groups were continuously treated for 12 weeks.The efficacy and renal function indexes of two groups were compared.Results The total effective rates of observation group and control group were 97.67% and 79.07%,respectively,and the difference was statistically significance（P〈0.05）.The levels of treatment urea nitrogen（BUN）,serum creatinine（Scr）,24 hurine protein of observation groups were（4.33±1.24）mmol/L,（85.36±5.85）mol/L and（1.89±0.24）g after treatment,which were all significantly lower than that of the control group[（6.32±2.02）mmol/L,（158.25±8.36）mol/L and（4.22±0.32）g]（P〈0.05）.Meanwhile,endogenous creatinine clearance rate（Ccr）（85.98±14.02）was significantly higher than that of the control group（68.23±12.02）（P〈0.05）.The levels of renal vascular index,blood pellets index,tubular-interstitial index,crescent index of observation group after treatment were（2.12±0.96）points,（2.12±0.88）points,（2.02±0.85）points and 0.22±0.08 respectively,which were significantly lower than that of the control group[（3.02±0.85）points,（3.85±1.22）points,（3.12±0.96）points and 0.48±0.10]（P〈0.05）.Adverse reaction rate between the two groups were not statistically significant（P〈0.05）.Conclusion Prednison combined with CTX can improve clinical efficacy of patients with IgA nephropathy,as well as improve renal function,which has lower rate of adverse reactions.In addition,it is a safe and effective method,which is worthy of clinical application.
出处
《检验医学与临床》
CAS
2016年第21期3043-3045,共3页
Laboratory Medicine and Clinic
