环孢素联合地尔硫[艹卓]辅助治疗原发性肾病综合征的临床观察

目的观察环孢素联合地尔硫艹卓];辅助治疗原发性肾病综合征的临床疗效。方法选取2015年6月-2018年6月山东省青岛市城阳区人民医院肾内科收治的原发性肾病综合征患者66例,根据治疗方法的不同分为观察组34例和对照组32例。对照组采用常规对症联合甲泼尼龙琥珀酸钠治疗,观察组在常规对症治疗的基础上使用环孢素联合地尔硫艹卓]治疗。比较2组患者临床疗效、治疗前后肾功能、凝血—纤溶指标及不良反应,肾功能包括24 h尿蛋白、血清白蛋白及血肌酐水平,凝血—纤溶指标包括凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)及D-二聚体(D-D)。结果观察组患者缓解率为76.47%,明显高于对照组的53.12%(χ²=3.957,P=0.047)。治疗后,2组患者24 h尿蛋白及血清白蛋白水平均显著改善(P<0.01),且观察组优于对照组(P<0.01);治疗后,2组患者PT、APTT、TT、D-D均明显优于治疗前(P<0.01),且观察组优于对照组(P<0.01);2组不良反应发生率比较差异无统计学意义(χ²=0.225,P=0.635)。结论环孢素联合地尔硫艹卓]辅助治疗原发性肾病综合征较单纯常规激素效果好,安全性高,并可有效改善凝血—纤溶系统。

Clinical observation of cyclosporine combined with diltiazem in the treatment of primary nephrotic syndrome

Objective To observe the clinical effect of cyclosporine combined with diltiazem in the treatment of primary nephrotic syndrome.Methods Sixty-six patients with primary nephrotic syndrome admitted to the Department of Nephrology,Chengyang People’s Hospital,Qingdao city,Shandong province,from June 2015 to June 2018 were selected.According to the different treatment methods,34 patients in the observation group and 32 patients in the control group were divided.The control group was treated with conventional symptomatic treatment combined with methylprednisolone succinate,while the observation group was treated with cyclosporine combined with diltiazem on the basis of conventional symptomatic treatment.Clinical curative effect,before and after the treatment of renal function,blood coagulation fibrinolytic indexes and adverse reactions between the 2 groups were compared,and renal function including the 24 h urine protein,serum albumin and serum creatinine,blood coagulation and fibrinolytic indexes including prothrombin time(PT),thrombin time(TT),fibrinogen(FIB),activated partial coagulation time(APTT)live enzymes and D-dimer(D-D).Results The remission rate in the observation group was 76.47%,which was significantly higher than that in the control group(53.12%)(χ²=3.957,P=0.047).After treatment,2 groups of patients 24 h urine protein and serum albumin levels were significantly improved(P<0.01),and the observation group was better than that of control group(P<0.01).After treatment,2 groups of patients PT,APTT,TT,D-D were better than before treatment(P<0.01),and the observation group was better than that of control group(P<0.01).There was no statistically significant difference in the incidence of adverse reactions between the 2 groups(χ²=0.225,P=0.635).Conclusion Cyclosporine combined with diltiazem in the adjuvant therapy of primary nephrotic syndrome is more effective and safe than conventional hormone therapy alone,and can effectively improve the coagulation and fibrinolysis system.