雷公藤多苷联合小剂量激素治疗特发性膜性肾病的疗效及其对患者血清ET-Ⅰ水平的影响

目的 探讨雷公藤多苷联合小剂量激素治疗特发性膜性肾病(IMN)的有效性和安全性,以及其对患者血清内皮素-Ⅰ(ET-Ⅰ)水平的影响.方法 选择府谷县人民医院和西安交通大学第二附属医院于2013年1月至2016年6月期间收治的IMN患者52例为研究对象,根据随机数表法将患者分为观察组和对照组,每组26例,对照组予抗血小板等常规治疗,观察组在此基础上联合雷公藤多苷及小剂量激素治疗,疗程1年.比较两组患者治疗前及治疗1年后的血肌酐、血清白蛋白(ALB)、甘油三酯(TG)、总胆固醇(TC)、24 h尿蛋白、ET-Ⅰ等生化指标的变化,并比较临床疗效.结果 治疗后,观察组患者的血清ALB为(36.7±6.4)g/L,明显高于对照组的(27.9±4.4)g/L,ET-Ⅰ、24 h尿蛋白、TC、TG水平分别为(42.5±9.3)pg/mL、(1.3±0.4)g、(6.2±2.1)mmol/L、(1.7±0.4)mmol/L,明显低于对照组的(50.6±10.5)pg/mL、(3.7±1.9)g、(8.4±2.4)mmol/L、(2.3±0.8)mmol/L,差异均有统计学意义(P<0.05);两组患者治疗后血肌酐水平比较差异无统计学意义(P>0.05);观察组患者的治疗总有效率为92.31%,明显高于对照组的69.23%,差异有统计学意义(P<0.05);两组患者不良反应发生率比较差异无统计学意义(P>0.05).结论 雷公藤多苷联合小剂量激素治疗IMN可有效改善患者的临床症状体征及内皮细胞功能,提高临床疗效,且具有较好的用药安全性.

Clinical effects of tripterygium glycosides combined with low dose of hormone on serum ET-I in the treatment of idiopathic membranous nephropathy

Objective To investigate the efficacy and safety of tripterygium glycosides combined with low dose hormone in the treatment of idiopathic membranous nephropathy (IMN). Methods A total of 52 patients with IMN, who were treated in Fugu County People's Hospital and Second Affiliated Hospital of Xi'an Jiao Tong University from January 2013 to June 2016, were selected and divided into the observation group (n=26) and the control group (n=26) according to random number method. The control group received antiplatelet therapy, and the observation group was treated with tripterygium glycosides combined with low-dose hormone therapy based on the treatment of the control group, for one year. The changes of biochemical indexes such as serum creatinine, serum albumin (ALB), tripterygium glycosides (TG), total cholesterol (TC), 24 h urinary protein were compared before and after one year of the treatment. Results After the treatment, ALB was (36.7 ± 6.4) g/L in the observation group versus (27.9 ± 4.4) g/L in the control group;the levels of ET-Ⅰ, 24 h urinary protein, TC and TG in the observation group were (42.5±9.3) pg/mL, (1.3±0.4) g, (6.2 ± 2.1) mmol/L, (1.7 ± 0.4) mmol/L, respectively, which were obviously lower than corresponding (50.6 ± 10.5) pg/mL, (3.7±1.9) g, (8.4±2.4) mmol/L, (2.3±0.8) mmol/L in the control group (P<0.05);there was no significant difference in se-rum creatinine between the two groups (P>0.05);the total efficiency of the observation group was 92.31%, which was significantly higher than 69.23% of the control group (P<0.05); there was no significant difference between the two groups in adverse reaction rate (P>0.05). Conclusion Tripterygium glycosides combined with low dose of hormone can effectively improve the clinical symptoms, signs and endothelial cell function of the patients in the treatment of IMN, and increase the clinical efficacy and endothelial cell function, which also has good drug safety.