羟氯喹联合治疗对IgA肾病残余蛋白尿的影响

目的 探讨羟氯喹(HCQ)联合肾素-血管紧张素系统抑制剂、激素和/或免疫抑制剂对IgA肾病患者残余蛋白尿的影响.方法 纳入2018年9月至2020年8月四川省人民医院活检为IgA肾病的门诊患者,HCQ联合治疗组28例和对照组46例,均随访6个月.比较两组患者随访期间残余蛋白尿下降率以及残余蛋白尿有效下降率的累积频率等....

The effect of hydroxychloroquine combination therapy on residual proteinuria in IgA nephropathy

Objective To explore the effect of hydroxychloroquine(HCQ)combined with renin-angiotensin system inhibitors(RASI),corticosteroids(P)and/or immunosuppressants(IM)on residual proteinuria in patients with IgA nephropathy.Methods A retrospectively case-control study was conducted.HCQ group(HCQ+RASI+P/IM group,n=28)and control group(RASI+P/IM group,n=46)were followed-up for 6 months.The baseline data,reduction rate of residual proteinuria during the follow-up period,and the cumulative frequency of the effective reduction rate of residual proteinuria were compared between the two groups.Results At the 6th month of treatment,the level of residual proteinuria in the HCQ group was significantly lower than that at the time of entry(P<0.001).The reduction rate of residual proteinuria in the HCQ group was significantly higher than that of the control group(P=0.034).During the follow-up period,the HCQ group showed more rapid percentage changes in residual urinary protein excretion compared to the control group.There was no significant difference in the cumulative frequency of the effective reduction rate of residual urine protein between the two groups(P=0.608).Conclusion On the basis of optimized supportive treatment,corticosteroids and immunosuppressants therapy combined with hydroxychloroquine can effectively reduce residual proteinuria in patients with IgA nephropathy.