摘要
[目的]探讨不同活性维生素D_(3)联合醋酸波尼松、环磷酰胺治疗膜性肾病(MN)的疗效.[方法]124例M N患者随机分为观察组和对照组,每组62例.两组均给予常规方法及环磷酰胺、醋酸波尼松治疗,对照组同时给予阿法骨化醇,观察组同时给予骨化三醇治疗.对比两组疗效,治疗前后氧化应激指标、肾足细胞损伤标志物情况及治疗期间药物安全性.[结果]两组治疗后的尿蛋白均低于治疗前(P<0.05),且观察组低于对照组(P<0.05).观察组总有效率高于对照组(P<0.05).两组治疗后晚期蛋白氧化产物(AOPP)、活性氧簇(ROS)水平均低于治疗前(P<0.05),且观察组均低于对照组(P<0.05);两组治疗后超氧化物歧化酶(SOD)水平均高于治疗前(P<0.05),且观察组高于对照组(P<0.05).两组治疗后尿液的podocalyxin、Nephrin水平均低于治疗前(P<0.05),且观察组均低于对照组(P<0.05).两组总不良反应发生率比较,差异无统计学意义(P>0.05).[结论]骨化三醇联合醋酸波尼松、环磷酰胺治疗M N可增强疗效,改善患者氧化应激及肾足细胞损伤情况,且安全性良好.
【Objective】To investigate the effect of different active vitamin D_(3) combined with prednisone acetate and cyclophosphamide on membranous nephropathy(MN),oxidative stress and markers of renal podocyte injury.【Methods】A total of 124 MN patients were randomly divided into observation group and control group,62 patients in each group.The two groups were treated with conventional methods,cyclophosphamide and prednisone acetate.The control group was treated with alfacalciferol,and the observation group was treated with calcitriol.The therapeutic effects,markers of oxidative stress and renal podocyte injury before and after treatment,and drug safety during treatment were compared between the two groups.【Results】The urinary protein of the two groups after treatment was lower than that before treatment(P<0.05),and that of the observation group was lower than that of the control group(P<0.05).The total effective rate of the observation group was higher than that of the control group(P<0.05).The levels of advanced protein oxidation products(AOPP)and reactive oxygen species(ROS)in the two groups after treatment were lower than those before treatment(P<0.05),and those in the observation group were lower than those in the control group(P<0.05);After treatment,the level of superoxide dismutase(SOD)in both groups was higher than that before treatment(P<0.05),and that in the observation group was higher than that in the control group(P<0.05).The levels of urine podophyxin and Nephrin in the two groups after treatment were lower than those before treatment(P<0.05),and those in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of total adverse reactions between the two groups(P>0.05).【Conclusion】The combination of calcitriol,prednisone acetate and cyclophosphamide in the treatment of MN can enhance the curative effect,improve the oxidative stress and renal podocyte injury in patients with MN,and has good safety.
作者
周淑娟
黄静瑾
ZHOU Shu-juan;HUANG Jing-jin(Department of Nephrology,People's Hospital of Yan'an,Yan'an Shaanxi 716000)
出处
《医学临床研究》
CAS
2023年第1期105-107,111,共4页
Journal of Clinical Research
