尿毒清对早期IgA肾病高血压型患者肾脏保护作用的临床研究  

The renoprotective effect of Niaoduqing treatment for early stage of patients with IgA ne- phropathy presented with hypertension

作　　者：赵玉[1] 王静[1] 王文革[1] 王晓玲[1] 赵俊丽[1] 孔玉科[1] 曾嵘[1] 王俭勤[1] 

机构地区：[1]兰州大学第二医院肾内科,甘肃730030

出　　处：《国际泌尿系统杂志》2012年第5期607-610,共4页International Journal of Urology and Nephrology

摘　　要：目的探讨尿毒清对早期高血压型IgA肾病患者的临床疗效。方法早期高血压型IgA肾病患者，随机分为尿毒清治疗组及非尿毒清对照组，采用前瞻性、双盲、对照研究的方法，进行两组尿蛋白缓解率、完全缓解率以及肌酐倍增、e—GFR变化、终末期肾功能衰竭发生率、重复肾活检指标的比较。结果49例患者随机分为治疗组（25例）和对照组（24例），两组基本病情无差异。两组治疗6个月尿蛋白缓解率及完全缓解率无统计学意义。40例随访（随访时间6～30个月，中位时间为24个月），治疗组肌酐倍增发生率明显低于对照组，分别为14．3％和42．1％（P〈0．05），前组肌酐倍增时间延长，两组均无患者进展至终末期肾功能衰竭。随访末尿毒清治疗组e—GFR指标明显高于对照组（87．38±17．9ml／分vs．76．05±23．5ml／分，P=0．007）。4例患者（治疗组1例，对照组3例）在随访24个月行重复肾活检，其肾小球硬化及肾小管间质慢性化改变均较首次肾活检时加重。结论尿毒清通过延缓肾功能进展，可用于早期高血压型I酗肾病患者的治疗，成为此类患者早期治疗的一种方法。Objectives To explore the effect of Niaoduqing treatment for early stage of patients with IgA nephropathy presented with hypertension. Methods A prospective study was performed on early stage of Ig, A nephropathy patients presented with hypertension, which were randomly divided into two groups ： the Niaoduqing group and the control group. The baseline characteristics between the two groups were similar, the efficacy and the outcomes were compared. Results 25 patients in Niaoduqing group and 24 patients in the control group, the total remission rate （complete remission and partial remission） and the complete remission rate were similar between the two groups. 40 patients had follow - up, the median follow - up was 30 months ranged from 6 to 30 months. The rate of doubling of the initial serum creatinine were significantly lower in Niaoduqing group compared to the control group （ 14.3 % and 42.1%, respectively, P 〈 0.05 ）. Kaplan - Meier analysis showed the time of doubling of the initial serum creatinine in Niaoduqing group was extended. No patients developed end stage renal disease. Estimates GFR were higher in patients with Niaoduqing group （ 87.38 ± 17.9 ml/min vs. 76.05 ± 23.5 ml/min, P = 0. 007 ）. Conclusions Niaoduqing can be a choice of the treatment for early stage of patients with lgA nephropathy presented with hypertension.

关 键 词：肾小球 肾炎 IGA 高血压 

分 类 号：R692.31[医药卫生—泌尿科学]