黑龙江医学
黑龍江醫學
흑룡강의학
HEILONGJIANG MEDICAL JOURNAL
2014年
7期
763-765
,共3页
王海涛%张奡%雷天香%付菊荣%李桂明
王海濤%張奡%雷天香%付菊榮%李桂明
왕해도%장오%뢰천향%부국영%리계명
多靶点疗法%慢性进展性中重型IgA肾病%药物治疗学
多靶點療法%慢性進展性中重型IgA腎病%藥物治療學
다파점요법%만성진전성중중형IgA신병%약물치료학
Multi target therapy%Moderate and severe IgA nephropathy%Pharmacotherapeutics
目的：探讨多靶点疗法治疗慢性进展性中重型IgA肾病的临床疗效。方法选择确诊为慢性进展性中重型IgA肾病患者84例，按随机数字法均分为观察组与对照组。对照组给予贝那普利、缬沙坦及泼尼松治疗，观察组接受尿激酶、霉酚酸酯、泼尼松、贝那普利及缬沙坦等多药联合多靶点治疗，疗程均为12个月。疗程结束后比较两组临床疗效、平均动脉压（ MAP）、24 h尿蛋白定量、血清白蛋白（ ALB）及内生肌酐清除率（ Ccr）等。结果对照组临床疗效总有效率为73.0％，观察组为90.0％，两组临床疗效比较，有显著性差异（ Z＝2.068， P＝0.039）。观察组与对照组治疗前MAP、24 h尿蛋白定量、ALB及Ccr水平之间比较，差异均无统计学意义（ P＝0.819，P＝0.732，P＝0.509， P＝0.244），治疗后两组之间比较，各指标变化均有显著性差异（ P＝0.017， P＝0.006， P＝0.000， P＝0.000）；对照组及观察组各指标治疗前后自身比较，差异均有统计学意义（均P＜0.05）。两组除5例因剧烈咳嗽退出外，无严重不良反应发生。结论多药联合多靶点治疗慢性进展性中重型IgA肾病安全有效。
目的：探討多靶點療法治療慢性進展性中重型IgA腎病的臨床療效。方法選擇確診為慢性進展性中重型IgA腎病患者84例，按隨機數字法均分為觀察組與對照組。對照組給予貝那普利、纈沙坦及潑尼鬆治療，觀察組接受尿激酶、黴酚痠酯、潑尼鬆、貝那普利及纈沙坦等多藥聯閤多靶點治療，療程均為12箇月。療程結束後比較兩組臨床療效、平均動脈壓（ MAP）、24 h尿蛋白定量、血清白蛋白（ ALB）及內生肌酐清除率（ Ccr）等。結果對照組臨床療效總有效率為73.0％，觀察組為90.0％，兩組臨床療效比較，有顯著性差異（ Z＝2.068， P＝0.039）。觀察組與對照組治療前MAP、24 h尿蛋白定量、ALB及Ccr水平之間比較，差異均無統計學意義（ P＝0.819，P＝0.732，P＝0.509， P＝0.244），治療後兩組之間比較，各指標變化均有顯著性差異（ P＝0.017， P＝0.006， P＝0.000， P＝0.000）；對照組及觀察組各指標治療前後自身比較，差異均有統計學意義（均P＜0.05）。兩組除5例因劇烈咳嗽退齣外，無嚴重不良反應髮生。結論多藥聯閤多靶點治療慢性進展性中重型IgA腎病安全有效。
목적：탐토다파점요법치료만성진전성중중형IgA신병적림상료효。방법선택학진위만성진전성중중형IgA신병환자84례，안수궤수자법균분위관찰조여대조조。대조조급여패나보리、힐사탄급발니송치료，관찰조접수뇨격매、매분산지、발니송、패나보리급힐사탄등다약연합다파점치료，료정균위12개월。료정결속후비교량조림상료효、평균동맥압（ MAP）、24 h뇨단백정량、혈청백단백（ ALB）급내생기항청제솔（ Ccr）등。결과대조조림상료효총유효솔위73.0％，관찰조위90.0％，량조림상료효비교，유현저성차이（ Z＝2.068， P＝0.039）。관찰조여대조조치료전MAP、24 h뇨단백정량、ALB급Ccr수평지간비교，차이균무통계학의의（ P＝0.819，P＝0.732，P＝0.509， P＝0.244），치료후량조지간비교，각지표변화균유현저성차이（ P＝0.017， P＝0.006， P＝0.000， P＝0.000）；대조조급관찰조각지표치료전후자신비교，차이균유통계학의의（균P＜0.05）。량조제5례인극렬해수퇴출외，무엄중불량반응발생。결론다약연합다파점치료만성진전성중중형IgA신병안전유효。
Objective To investigate the clinical effect of multi target therapy in treatment of chronic moderate and severe IgA ne-phropathy.Methods 84patientswithchronicprogressivemoderateandsevereIgAnephropathyconfirmedbybiopsywereenrolledand randomly equally divided into observation group and control group.The patients in observation group were treated with urokinase ,predni-sone, mycophenolate mofetil , benner pury and valsartan , while those in control group were treated with prednisone , benner pury and valsar-tan.After 12 months treatment, the clinical efficacy, mean arterial pressure (MAP), 24h urine protein, serum albumin (ALB) and creati-nine clearance rate ( Ccr) were analyzed.Results The total clinical effectiveness of control group was 73.0% and that of observation group was 90.0%.There was significant difference between two groups (Z=2.068, P=0.039).About the level of MAP , albumin, 24 hour urinary protein and Ccr , there were no significant differences before treatment between two groups ( P =0.819 , P =0.732 , P=0.509 , P=0.244 ) , while after treatment there were significant differences between two groups ( P=0.017 , P=0.006 , P=0.000 , P=0.000 ).There were all significant differences in each index of the two groups after being compared before and after treatment ( P <0.05).Except for severe cough in two groups , there were no serious adverse reactions.Conclusions Multi target therapy of multi drugs combined is effective and safe in treatment of chronic progressive moderate and severe IgA nephropathy .
