摘要
目的探究环磷酰胺(CTX)联合糖皮质激素对新月体性IgA肾病(IgAN)患者疗效及肾功能的影响。方法选择2020年1月—2022年1月安阳地区医院收治的88例新月体性IgAN患者,利用随机数字表法分为对照组(44例,采用糖皮质激素治疗)与研究组(44例,采用CTX联合糖皮质激素治疗),收集患者的临床资料并比较两组患者的临床疗效、肾功能、血压的影响。结果与对照组相比,研究组的总有效率显著增加(P<0.05)。治疗前,两组新月体性IgAN患者的血尿素氮(BUN)、血肌酐(SCr)、肾小球滤过率(GFR)、24 h尿蛋白定量(24 h UPRO)、尿红细胞数、血压比较差异均不明显(P>0.05);治疗后,研究组新月体性IgAN患者的BUN[(9.75±1.34)mmol/L vs(15.53±3.02)mmol/L]、Scr[(100.83±19.78)μmol/L vs(204.42±40.23)μmol/L]、24 h UPRO[(0.83±0.16)g vs(1.93±0.47)g]、尿红细胞数[(42.85±8.82)×104/mL vs(802.99±99.06)×104/mL]、血压明显降低(P<0.05),GFR[(69.45±15.38)mL/min vs(37.79±9.05)mL/min]明显升高(P<0.05)。研究组出现不良反应的总发生率与对照组相比差异无统计学意义(P>0.05)。结论CTX联合糖皮质激素治疗新月体性IgAN的效果确切,能够改善患者的肾功能,从而降低进展终末期肾病(ESKD)的风险,该治疗方法安全性好,值得应用。
Objective To investigate the effect of cyclophosphamide(CTX)combined with glucocorticoid on the efficacy and renal function in patients with crescentic IgA nephropathy(IgAN).Methods A total of 88 patients with crescentic IgAN ad⁃mitted to our hospital from January 2020 to January 2022 were selected and divided into a control group(44 cases,treated with glucocorticoids)and a study group(44 cases,treated with CTX combined with glucocorticoids)by the random number table method.The clinical data of the patients were collected and the clinical efficacy,renal function,and blood pressure of the two groups were compared.Results Compared with the control group,the total effective rate of the study group was obviously in⁃creased(P<0.05).Before treatment,there were no significant differences in blood urea nitrogen(BUN),serum creatinine(SCr),glomerular filtration rate(GFR),24 h urinary protein quantitation(24 h UPRO),urinary red blood cell count and blood pressure between the two groups of crescentic IgAN patients(P>0.05).After treatment,BUN[(9.75±1.34)mmol/L vs(15.53±3.02)mmol/L],Scr[(100.83±19.78)μmol/L vs(204.42±40.23)μmol/L],24 h UPRO[(0.83±0.16)g vs(1.93±0.47)g],urine red blood cell count[(42.85±8.82)×104/mL vs(802.99±99.06)×104/mL]and blood pressure of crescentic IgAN patients in the study group were significantly decreased(P<0.05),and GFR[(69.45±15.38)mL/min vs(37.79±9.05)mL/min]was significantly increased(P<0.05).The total incidence of adverse reactions in the study group was not obviously different from that in the control group(P>0.05).Conclusion CTX combined with glucocorticoids is effective in the treatment of crescentic IgAN,which can improve the renal function of patients,thereby re⁃ducing the risk of progressive end-stage renal disease(ESKD).This treatment method is safe and worthy of application.
作者
辛卫丽
孙晓莉
郭永兵
张俊霞
XIN Wei-li;SUN Xiao-li;GUO Yong-bing;ZHANG Jun-xia(Nephrology Rheumatoid Dept.,Anyang Regional Hospital,Anyang,Henan 455000,China)
出处
《医药论坛杂志》
2024年第5期533-537,共5页
Journal of Medical Forum
基金
濮阳市科技攻关计划项目(1805071)。
关键词
环磷酰胺
糖皮质激素
新月体
IGA肾病
肾功能
Cyclophosphamide
Glucocorticoid
Crescent
IgA nephropathy
Renal function
