中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2014年
21期
3238-3240,3241
,共4页
肾小球肾炎,膜性%环磷酰胺%环孢素A
腎小毬腎炎,膜性%環燐酰胺%環孢素A
신소구신염,막성%배린선알%배포소A
Glomerulonephritis,Membranous%Cyclophosphamide%Cyclosporine A
目的:比较小剂量激素联合环孢素A( CsA)与足量糖皮质激素联合环磷酰胺( CTX)两种方案治疗特发性膜性肾病( IMN)的疗效及安全性。方法将42例IMN患者按照数字表法随机分为A组和B组,每组21例。在相同的基础治疗上,A组给予足量糖皮质激素联合CTX治疗,B组予小剂量激素联合CsA治疗。检测比较两组治疗前、治疗3个月、6个月、12个月的24 h尿蛋白定量(24 h Upro)、血肌酐( CR)、谷氨酸氨基转移酶( ALT)、血白蛋白( ALB)、血糖( GLU)等指标,比较两组完全缓解率、部分缓解率、复发率及不良反应。结果治疗前两组各指标差异均无统计学意义(均P>0.05),其中A组24 h Upro(5.3±2.1)g/L,ALB (21.8±8.1)g/L,B组24 h Upro(5.4±2.3)g/L,ALB(20.3±7.5)g/L;治疗3个月时,两组24 h Upro均显著下降,ALB显著升高,A组24 h Upro(3.2±1.2) g/L,ALB(27.9±7.6) g/L,B组24 h Upro(3.5±1.3) g/L, ALB(26.4±8.1)g/L,两组24 h Upro均呈逐渐下降趋势(F=5.216,P<0.05),ALB呈逐渐上升趋势(F=5.864,P<0.05)。在不同时间点,两组总缓解率差异均无统计学意义(P>0.05)。 A组复发率9.5%,B组复发率14.3%,两组差异亦无统计学意义(P>0.05)。 A组不良反应发生率为23.8%,B组不良反应发生率为28.6%,两组差异无统计学意义(P>0.05)。结论激素联合CTX与激素联合CsA两种方案对IMN的疗效相近,临床治疗中,可结合患者的具体情况,制定个体化的治疗方案。
目的:比較小劑量激素聯閤環孢素A( CsA)與足量糖皮質激素聯閤環燐酰胺( CTX)兩種方案治療特髮性膜性腎病( IMN)的療效及安全性。方法將42例IMN患者按照數字錶法隨機分為A組和B組,每組21例。在相同的基礎治療上,A組給予足量糖皮質激素聯閤CTX治療,B組予小劑量激素聯閤CsA治療。檢測比較兩組治療前、治療3箇月、6箇月、12箇月的24 h尿蛋白定量(24 h Upro)、血肌酐( CR)、穀氨痠氨基轉移酶( ALT)、血白蛋白( ALB)、血糖( GLU)等指標,比較兩組完全緩解率、部分緩解率、複髮率及不良反應。結果治療前兩組各指標差異均無統計學意義(均P>0.05),其中A組24 h Upro(5.3±2.1)g/L,ALB (21.8±8.1)g/L,B組24 h Upro(5.4±2.3)g/L,ALB(20.3±7.5)g/L;治療3箇月時,兩組24 h Upro均顯著下降,ALB顯著升高,A組24 h Upro(3.2±1.2) g/L,ALB(27.9±7.6) g/L,B組24 h Upro(3.5±1.3) g/L, ALB(26.4±8.1)g/L,兩組24 h Upro均呈逐漸下降趨勢(F=5.216,P<0.05),ALB呈逐漸上升趨勢(F=5.864,P<0.05)。在不同時間點,兩組總緩解率差異均無統計學意義(P>0.05)。 A組複髮率9.5%,B組複髮率14.3%,兩組差異亦無統計學意義(P>0.05)。 A組不良反應髮生率為23.8%,B組不良反應髮生率為28.6%,兩組差異無統計學意義(P>0.05)。結論激素聯閤CTX與激素聯閤CsA兩種方案對IMN的療效相近,臨床治療中,可結閤患者的具體情況,製定箇體化的治療方案。
목적:비교소제량격소연합배포소A( CsA)여족량당피질격소연합배린선알( CTX)량충방안치료특발성막성신병( IMN)적료효급안전성。방법장42례IMN환자안조수자표법수궤분위A조화B조,매조21례。재상동적기출치료상,A조급여족량당피질격소연합CTX치료,B조여소제량격소연합CsA치료。검측비교량조치료전、치료3개월、6개월、12개월적24 h뇨단백정량(24 h Upro)、혈기항( CR)、곡안산안기전이매( ALT)、혈백단백( ALB)、혈당( GLU)등지표,비교량조완전완해솔、부분완해솔、복발솔급불량반응。결과치료전량조각지표차이균무통계학의의(균P>0.05),기중A조24 h Upro(5.3±2.1)g/L,ALB (21.8±8.1)g/L,B조24 h Upro(5.4±2.3)g/L,ALB(20.3±7.5)g/L;치료3개월시,량조24 h Upro균현저하강,ALB현저승고,A조24 h Upro(3.2±1.2) g/L,ALB(27.9±7.6) g/L,B조24 h Upro(3.5±1.3) g/L, ALB(26.4±8.1)g/L,량조24 h Upro균정축점하강추세(F=5.216,P<0.05),ALB정축점상승추세(F=5.864,P<0.05)。재불동시간점,량조총완해솔차이균무통계학의의(P>0.05)。 A조복발솔9.5%,B조복발솔14.3%,량조차이역무통계학의의(P>0.05)。 A조불량반응발생솔위23.8%,B조불량반응발생솔위28.6%,량조차이무통계학의의(P>0.05)。결론격소연합CTX여격소연합CsA량충방안대IMN적료효상근,림상치료중,가결합환자적구체정황,제정개체화적치료방안。
Objective To compare the clinical efficacy and safety between cyclosporine A combined with low-dose hormone and progestin hormone combined cyclophosphamide( CTX) in the treatment of idiopathic membra-nous nephropathy( IMN) .Methods 42 patients with IMN were randomly divided into group A and group B according to a random number table,21 cases in each group.On the same basic treatment,group A was given adequate glucocor-ticoid and CTX therapy,group B was given small doses of hormones combined with CsA.24hUpro,CR,ALT,ALB and GLU of the two groups at before treatment and 3 months,6 months,12 months after treatment were compared.And the complete remission rate,partial remission rate, relapse rate and adverse reactions in the two groups were also com-pared.Results The indicators of the two groups before treatment showed no significant difference,and 24hUpro of group A was (5.3 ±2.1)g/L,ALB was (21.8 ±8.1)g/L,while 24hUpro of group B was (5.4 ±2.3)g/L,ALB was (20.3 ±7.5)g/L,and 3 months of treatment,24hUpro was significantly decreased significantly and ALB increased in the two groups,24hUpro of group A was (3.2 ±1.2)g/L,ALB was (27.9 ±7.6)g/L,24hUpro of group B was (3.5 ± 1.3)g/L,ALB was (26.4 ±8.1)g/L.24hUpro showed a gradual downward trend(F=5.216,P<0.05),ALB showed a gradual upward trend(F=5.864,P<0.05).At different time points,the overall response rate between the two groups was no significant difference(P>0.05).The recurrence rate was 9.5% in group A,group B recurrence rate was 14.3%,which has no significant difference(P>0.05).The occurrence rate of adverse reactions of group A was 23.8 %and 28.6%in group,the difference between the two groups was not statistically significant(P>0.05). Conclusion The treatment of progestin hormone combined CTX has similar efficacy with CsA,and in clinical treat-ment,develop individualized treatment programs can be chosen according to the specific circumstances of the patients.