摘要
目的分析雷公藤多苷联合甲泼尼龙治疗原发性肾病综合征(PNS)的效果及对肾功能、免疫功能的影响。方法选取2017年9月—2019年9月本院收治的91例PNS为研究对象,按照治疗方式分为观察组48例和对照组43例。观察组给予雷公藤多苷联合甲泼尼龙治疗,对照组给予甲泼尼龙治疗。比较2组临床疗效,治疗前后免疫功能[免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)],肾功能(24 h尿蛋白定量、血肌酐、尿素),血清糖类抗原[糖类抗原125(CA125)、糖类抗原15-3(CA15-3)、糖类抗原19-9(CA19-9)]水平及不良反应发生情况。结果观察组治疗总有效率高于对照组(P<0.05)。与治疗前比较,2组治疗后IgA、IgG水平升高,IgM水平降低,且观察组较对照组变化更显著,差异有统计学意义(P<0.05,P<0.01)。与治疗前比较,观察组治疗后24 h尿蛋白定量、血肌酐、尿素显著降低,且观察组低于对照组(P<0.05,P<0.01)。与治疗前比较,2组治疗后CA125、CA15-3、CA19-9水平降低,且观察组低于对照组,差异有统计学意义(P<0.05,P<0.01)。观察组并发症发生率低于对照组(P<0.05)。结论雷公藤多苷联合甲泼尼龙治疗PNS,可改善患者肾功能,提高免疫功能,下调其血清类抗原表达,临床疗效显著,安全性高。
Objective To analyze the effectiveness of Tripterygium Glycosides combined with Methylprednisolone in treatment of patients with primary nephrotie sydrome(PNS)and its effects on renal function and immune function.Methods A total of 91 patients with PNS admitted between September 2017 and September 2019 were selected,and the patients were divided into observation group(n=48)and control group(n=43)according to different therapeutic methods.Observation group was treated with Tripterygium Glycosides combined with Methylprednisolone,while control group was treated with Methylprednisolone only.Clinical efficacy,levels of immune function[immunoglobin A(IgA),immunoglobin G(IgG),immunoglobulin M(IgM)],renal function[24 h urine protein quantification,serum creatinine(Scr),blood urea nitrogen(BUN)],serum carbohydrate antigen[carbohydrate antigen 125(CA125),carbohydrate antigen 15-3(CA15-3),carbohydrate antigen 19-9(CA19-9)]before and after treatment and incidence rate of adverse reactions were compared between two groups.Results The total effective rate in observation group was significantly higher than that in control group(P<0.05).Compared with those before treatment,levels of IgA and IgG were significantly increased,while IgM levels were significantly decreased after treatment in two groups,and changes of the above indexes in observation group were more significant compared with those in control group(P<0.05,P<0.01).Compared with those before treatment,levels of 24 h urinary protein quantification,Scr and BUN were significantly decreased after treatment in two groups,and the levels in observation group were significantly lower than those in control group(P<0.05,P<0.01).Compared with those before treatment,levels of CA125,CA15-3 and CA19-9 were significantly decreased after treatment in two groups,and the levels in observation group were significantly lower than those in control group(P<0.05,P<0.01).Incidence rate of complications in observation group was significantly lower than that in control group(P<0.05).Conclusion Tripterygium Glycosides combined with Methylprednisolone may improve renal function,improve immune function and down-regulate expressions of serum antigens with good clinical efficacy and safety in treatment of patients with PNS.
作者
姜传学
董葆
王建
宋东旭
李龙海
JIANG Chuan-xue;DONG Bao;WANG Jian;SONG Dong-xu;LI Long-hai(Department of Nephropathy,the Second People's Hospital of Fuyang,Fuyang,Anhui 236015,China;Department of Nephropathy,People's Hospital of Peking University,Beijing 100044,China)
出处
《解放军医药杂志》
CAS
2021年第8期87-91,共5页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
2017年安徽省自然科学基金项目(1708085MH267)。
