疑难病杂志
疑難病雜誌
의난병잡지
Chinese Journal of Difficult and Complicated Cases
2015年
11期
1151-1153,1165
,共4页
吗替麦考酚酯%环磷酰胺%IgA肾病%尿蛋白%血管内皮生长因子
嗎替麥攷酚酯%環燐酰胺%IgA腎病%尿蛋白%血管內皮生長因子
마체맥고분지%배린선알%IgA신병%뇨단백%혈관내피생장인자
Mycophenolate mofetil%Cyclophosphamide%IgA nephropathy%Urine protein%Vascular endothelial growth factor
目的:观察吗替麦考酚酯联合环磷酰胺( CTX)对IgA肾病患者和血清血管内皮生长因子( VEGF)水平的影响。方法选取2012年3月—2015年3月IgA肾病患者96例,根据随机数字表将患者分为观察组及对照组各48例。对照组给予吗替麦考酚酯持续治疗12个月,观察组在对照组基础上静脉滴注环磷酰胺1000 mg/次,每月1次,连续应用6个月。观察治疗1年后疗效、对比分析2组治疗前后肾功能及VEGF等指标的变化。结果观察组总有效率为95 q.83%,高于对照组的79.17%(χ2=6.095, P =0.013)。与治疗前比较,2组治疗后SCr、BUN、24 hUP、VEGF均降低、CCr升高,差异均有统计学意义( P <0.05);治疗后BUN(4.33±1.24)mmol/L、SCr(86.92±14.67)μmol/L、24hUP(42.86±5.26)mg/24h、VEGF(109.64±23.78)ng/ml低于对照组的(7.98±2.53)mmol/L、(102.16±21.25)μmol/L、(85.36±4.28) mg/24h、(135.25±26.47) ng/ml,差异均有统计学意义( t =5.754、4.824、7.265、5.963、5.469, P <0.05),而观察组Ccr为(55.98±22.02)ml/min,高于对照组的(46.32±18.63)ml/min( t =5.963, P =0.000)。观察组不良反应率为6.25%(3/48),对照组为10.42%(5/48),差异比较无统计学意义(χ2=0.545, P =0.462)。结论吗替麦考酚酯联合环磷酰胺能有效提高IgA肾病患者临床治疗效果,改善患者肾功能,安全有效,其作用机制可能与VEGF表达下调有关。
目的:觀察嗎替麥攷酚酯聯閤環燐酰胺( CTX)對IgA腎病患者和血清血管內皮生長因子( VEGF)水平的影響。方法選取2012年3月—2015年3月IgA腎病患者96例,根據隨機數字錶將患者分為觀察組及對照組各48例。對照組給予嗎替麥攷酚酯持續治療12箇月,觀察組在對照組基礎上靜脈滴註環燐酰胺1000 mg/次,每月1次,連續應用6箇月。觀察治療1年後療效、對比分析2組治療前後腎功能及VEGF等指標的變化。結果觀察組總有效率為95 q.83%,高于對照組的79.17%(χ2=6.095, P =0.013)。與治療前比較,2組治療後SCr、BUN、24 hUP、VEGF均降低、CCr升高,差異均有統計學意義( P <0.05);治療後BUN(4.33±1.24)mmol/L、SCr(86.92±14.67)μmol/L、24hUP(42.86±5.26)mg/24h、VEGF(109.64±23.78)ng/ml低于對照組的(7.98±2.53)mmol/L、(102.16±21.25)μmol/L、(85.36±4.28) mg/24h、(135.25±26.47) ng/ml,差異均有統計學意義( t =5.754、4.824、7.265、5.963、5.469, P <0.05),而觀察組Ccr為(55.98±22.02)ml/min,高于對照組的(46.32±18.63)ml/min( t =5.963, P =0.000)。觀察組不良反應率為6.25%(3/48),對照組為10.42%(5/48),差異比較無統計學意義(χ2=0.545, P =0.462)。結論嗎替麥攷酚酯聯閤環燐酰胺能有效提高IgA腎病患者臨床治療效果,改善患者腎功能,安全有效,其作用機製可能與VEGF錶達下調有關。
목적:관찰마체맥고분지연합배린선알( CTX)대IgA신병환자화혈청혈관내피생장인자( VEGF)수평적영향。방법선취2012년3월—2015년3월IgA신병환자96례,근거수궤수자표장환자분위관찰조급대조조각48례。대조조급여마체맥고분지지속치료12개월,관찰조재대조조기출상정맥적주배린선알1000 mg/차,매월1차,련속응용6개월。관찰치료1년후료효、대비분석2조치료전후신공능급VEGF등지표적변화。결과관찰조총유효솔위95 q.83%,고우대조조적79.17%(χ2=6.095, P =0.013)。여치료전비교,2조치료후SCr、BUN、24 hUP、VEGF균강저、CCr승고,차이균유통계학의의( P <0.05);치료후BUN(4.33±1.24)mmol/L、SCr(86.92±14.67)μmol/L、24hUP(42.86±5.26)mg/24h、VEGF(109.64±23.78)ng/ml저우대조조적(7.98±2.53)mmol/L、(102.16±21.25)μmol/L、(85.36±4.28) mg/24h、(135.25±26.47) ng/ml,차이균유통계학의의( t =5.754、4.824、7.265、5.963、5.469, P <0.05),이관찰조Ccr위(55.98±22.02)ml/min,고우대조조적(46.32±18.63)ml/min( t =5.963, P =0.000)。관찰조불량반응솔위6.25%(3/48),대조조위10.42%(5/48),차이비교무통계학의의(χ2=0.545, P =0.462)。결론마체맥고분지연합배린선알능유효제고IgA신병환자림상치료효과,개선환자신공능,안전유효,기작용궤제가능여VEGF표체하조유관。
Objective To observe the effect of mycophenolate mofetil combined cyclophosphamide ( CTX) on IgA ne-phropathy and serum vascular endothelial growth factor (VEGF) in patients with diabetic nephropathy.Methods Ninty-six patients with IgA nephropathy from March 2012 to March 2015 were enrolled and divided into observation group and control group with 48 cases in each group.The control group was given to the mycophenolate mofetil continuous treatment of 12 months, the observation group on the basis of treatment in the control group, also intravenous infusion of cyclophosphamide 1000 mg/times, 1 times a month, for 6 consecutive months.After 1 years of treatment, the effect of the 2 groups were com-pared and analyzed the renal function and VEGF and other indicators of change before and after treatment.Results The total efficiency of observation group was 95.83%, which was higher than 79.17%in the control group (χ2 =6.095, P =0.013). Compared with before treatment, SCr increased, BUN, 24 hUP, VEGF, CCr were decreased after the treatment in the 2 groups, the difference was statistically significant ( P <0.05); after the treatment, BUN (4.33 ±1.24) mmol/L, SCr (86.92 ± 14.67) mol/L, 24hUP (42.86 ±5.26) mg/24h, VEGF (109.64 ±23.78) ng/ml were lower than that of the control group (7.98 ±2.53) mmol/L, (102.16 ±21.25) mol/L, (85.36 ±4.28) mg/24h,(135.25 ±26.47) ng/ml, the differences were statistically significant ( t =5.754, t =4.824, t =7.265, t =5.963, t =5.469, P <0.05);observation group's Ccr was(55.98 ±22.02) ml/min, which was higher than that of the control group(46.32 ±18.63) ml/min( t =5.963, P =0.000).The adverse reactions rate was 6.25%(3/48) in the observation group, control group was 10.42%(5/48),the difference between the two groups was not statistically significant(χ2 =0.545, P =0.462).Conclusion The clinical effect of mycophenolate mofetil combination of cyclophosphamide for IgA nephropathy patients with VEGF nephropathy can be effective.