促纤溶治疗对IgA肾病患者肾脏保护的回顾性队列研究  

Fibrinolytic therapy on renal protection in IgA nephropathy patients: a retrospective cohort study

作　　者：方明[1] 林洪丽[1] 谢华[1] 陈吉林[1] 孙艳玲[1] 刘盼盼[1] 

机构地区：[1]大连医科大学附属第一医院肾内科,116011

出　　处：《实用医学杂志》2014年第9期1405-1407,共3页The Journal of Practical Medicine

基　　金：辽宁省医学高峰建设工程项目(2011年)

摘　　要：目的:观察尿激酶或纤溶酶冲击治疗对IgA肾病患者的肾脏保护作用。方法:对84例IgA肾病患者资料进行回顾性分析,并根据是否使用促纤溶药物及使用药物的种类将患者分为对照组(n=23)、尿激酶组(n=32)和纤溶酶组(n=29),比较分析治疗6个月、1年3组患者的24 h尿蛋白定量、血生化、肾小球滤过率、凝血像。结果:3组患者24 h尿蛋白定量在治疗6个月和1年均较治疗前有统计学差异(P<0.01);组间比较:尿激酶组在治疗6个月及治疗1年时较对照组有统计学差异(P<0.01);纤溶酶组和对照组在治疗1年时有统计学差异(P<0.05)。在治疗1年时,尿激酶组肾小球滤过率改善,较对照组有统计学差异(P<0.05)。结论:在中重度IgA肾病患者,促纤溶治疗有独立于激素和免疫抑制剂之外的减少蛋白尿和肾脏保护作用。Objective To investigate the protective effect of fibrinolytic therapy on renal function in patients with IgA nephropathy. Methods The clinical data of 84 patients with idiopathic IgA nephropathy were analyzed in a retrospective cohort study. According to different drugs of fibrinolytic therapy, the patients were divided into three groups including control group（n =23）, urokinase group （n = 32） and fibrinogenase group （n = 29）. Twenty-four- hour urine protein excretion, serum albumin, estimated glomerular filtration rate （eGFR）, prothrombin time and fibrinogen level between the three groups after 6-month and 1-year treatments were compared. Results Compared to the group before treatment, the urine protein excretions were decreased in all 3 groups with 6-month and 1-year treatments （P 〈 0.01 ）. The urine protein excretion in the urokinase group with 6-month and 1-year treatments were lower than that in the control group （P 〈 0.01 ）. The urine protein excretion in the fibrinogenase group with 1-year treatment were lower that in the control group （P 〈 0.05 ）. After 1-year treatment, the eGFR in urokinase group was significantly increased compared with the control group （P 〈 0.05）. Conclusion Fibrinolytic therapy can decrease the 24-hour urine protein excretion and improve the renal fuction in those patients with idiopathic IgA nephropathy independent of glucocorticoids and immunosuppressive agents.

关 键 词：IGA肾病 尿激酶 纤溶酶 

分 类 号：R692.31[医药卫生—泌尿科学]