补肾活血法治疗慢性肾小球肾炎疗效观察

[目的] 观察补肾活血法治疗慢性肾小球肾炎的临床疗效。[方法] 100例患者随机分为两组,对照组50例和治疗组50例。对照组采用西医常规治疗,治疗组加用补肾活血的中药汤剂,12周后统计疗效。[结果] 治疗组总有效率为94%,与对照组比较差异有统计学意义（P<0.05）.两组经治疗后24 h尿蛋白定量、血尿素氮（BUN）均显着下降（P<0.01）,治疗组优于对照组。治疗组尿红细胞数、血肌酐（Scr）与治疗前相比显着下降,差异有统计学意义（P<0.01）.[结论] 补肾活血法对慢性肾小球肾炎有良好的疗效。     

缬沙坦联合小剂量苯磺酸左旋氨氯地平治疗慢性肾小球肾炎的临床观察

目的：观察缬沙坦胶囊联合小剂量苯磺酸左旋氨氯地平治疗慢性肾小球肾炎的临床效果。方法：选取2011年3月-2013年10月本院住院及门诊治疗的60例慢性肾小球肾炎患者,按照随机数字表法将其分为治疗组和对照组各30例。对照组给予缬沙坦口服,治疗组在对照组治疗基础上同时加用小剂量苯磺酸左旋氨氯地平2.5~5.0 mg/d,疗程12周,观察比较两组患者的治疗效果、治疗前后的血压及尿素氮、血肌酐及尿蛋白定量的变化。结果：治疗组的治疗总有效率96.7%（29/30）明显高于对照组的53.3%（16/30）,差异有统计学意义（P〈0.05）。与治疗前比较,两组治疗后24 h尿蛋白定量均有明显降低,且治疗组的尿蛋白定量明显低于对照组,差异均有统计学意义（P〈0.05）,而两组治疗前后的尿素氮、血肌酐均未见明显改变,不良反应也均未见明显差异（P〉0.05）。结论：缬沙坦联合小剂量苯磺酸左旋氨氯地平治疗慢性肾小球肾炎疗效显著,且无严重不良反应,值得临床推广。     

卡托普利联合川芎嗪治疗急性肾小球肾炎的临床效果观察

目的：观察卡托普利联合川芎嗪治疗急性肾小球肾炎的临床效果。方法选择80例急性肾小球肾炎患者为研究对象,随机分为观察组和对照组各40例。对照组给予常规治疗,观察组在常规治疗的基础上给予卡托普利联合川芎嗪治疗,比较两组的疗效。结果观察组血尿转阴率为75.00％,明显高于对照组的45.00％,差异具有统计学意义（P＜0.01）;观察组肉眼血尿消退时间为（2.5±0.5）d,镜下血尿消退时间为（2.6±0.6）d,水肿消退时间为（3.7±0.4）d,血压恢复时间为（4.1±0.6）d,均明显短于对照组,差异具有统计学意义（ P＜0.01）。结论在常规治疗基础上联合应用卡托普利与川芎嗪治疗急性肾小球肾炎能缩短疗程,提高疗效。     

HBV相关性肾炎的抗病毒治疗研究进展

HBV相关性肾炎(HBV-associated glomerulonephritis,HBV-GN)是HBV慢性感染最常见的肝外表现之一,主要表现为免疫复合物介导的肾小球疾病。这类患者情况特殊、病情复杂,通常须进行针对性的抗病毒治疗,故及时把握治疗时机以及正确选用抗病毒药物对HBV-GN治疗极为关键,但迄今为止仍无规范统一的治疗策略。本综述参考国内外最新信息,对HBV-GN的抗病毒治疗研究进展以及各抗病毒药物的疗效、安全性等进行总结,以期为临床决策提供参考。     

Hepatitis C virus associated glomerulopathies

Hepatitis C virus(HCV)infection is a systemic disorder which is often associated with a number of extrahepatic manifestations including glomerulopathies.Patients with HCV infection were found to have a higher risk of end-stage renal disease.HCV positivity has also been linked to lower graft and patient survivals after kidney transplantation.Various histological types of renal diseases are reported in association with HCV infection including membranoproliferative glomerulonephritis(MPGN),membranous nephropathy,focal segmental glomerulosclerosis,fibrillary glomerulonephritis,immunotactoid glomerulopathy,IgA nephropathy,renal thrombotic microangiopathy,vasculitic renal involvement and interstitial nephritis.The most common type of HCV associated glomerulopathy is typeⅠMPGN associated with typeⅡmixed cryoglobulinemia.Clinically,typical renal manifestations in HCV-infected patients include proteinuria,microscopic hematuria,hypertension,acute nephritis and nephrotic syndrome.Three approaches may be suggested for the treatment of HCV-associated glomerulopathies and cryoglobulinemic renal disease:(1)antiviral therapy to prevent the further direct damage of HCV on kidneys and synthesis of immune-complexes;(2)B-cell depletion therapy to prevent formation of immune-complexes and cryoglobulins;and(3)nonspecific immunosuppressive therapy targeting inflammatory cells to prevent the synthesis of immune-complexes and to treat cryoglobulin associated vasculitis.In patients with moderate proteinuria and stable renal functions,anti-HCV therapy is advised to be started as pegylated interferon-αplus ribavirin.However in patients with nephrotic-range proteinuria and/or progressive kidney injury and other serious extra-renal manifestations,immunosuppressive therapy with cyclophosphamide,rituximab,steroid pulses and plasmapheresis should be administrated.