多靶点疗法对合并高尿酸血症慢性进展性中重型IgA肾病的效果观察  

Clinical effect of multiple target therapy on severe IgA nephropathy with hyperuricemia of chronic progressive moderate

作　　者：王海涛[1] 张奡[1] 雷天香[1] 付菊荣[1] 李桂明[1] 

机构地区：[1]广东省第二中医院肾病科,广州510095

出　　处：《中国综合临床》2014年第12期1246-1249,共4页Clinical Medicine of China

基　　金：广东省医学科研基金立项课题（A2012127）

摘　　要：目的 探讨多靶点疗法对合并高尿酸血症慢性进展性中重型IgA肾病的临床效果.方法 选择我院合并高尿酸血症的慢性进展性中重型IgA肾病患者76例,按随机数字表分为两组,对照组给予别嘌醇、贝那普利、缬沙坦及泼尼松治疗,观察组在对照组基础上加用尿激酶、霉酚酸酯等多药联合多靶点治疗,疗程均为6个月.疗程结束后比较两组血尿酸、24h尿蛋白定量、平均动脉压（MAP）及内生肌酐清除率（Ccr）.结果 治疗前对照组与观察组血尿酸、24h尿蛋白定量、MAP及Ccr比较差异均无统计学意义（P均＞0.05）;治疗后观察组与对照组血尿酸[（413.7 ±90.7）、（369.6±67.2） μmol/L]、24h尿蛋白定量[（1.15±0.57）、（0.77 ±0.51） g/L]、MAP[（87.7±10.6）、（81.6 ±12.3） mmHg]、Ccr[（81.9±3.7）、（86.4 ±6.8）ml/min]比较差异均有统计学意义（t值分别为2.219、2.802、2.132、3.230,P均＜0.05）.对照组不良反应发生率为9.7％（3/31）;观察组为9.1％（3/33）,两组不良反应发生率比较,差异无统计学意义（x^2 =0.006,P=0.936）.结论 多靶点疗法治疗合并高尿酸血症慢性进展性中重型IgA肾病安全有效.Objective To explore the efficacy of multiple target therapy in treatment of patients with chronic moderate and severe IgA nephropathy with hyperuricemia.Methods Seventy-six patients with chronic progressive moderate and severe IgA nephropathy with hyperuricemia were enrolled the current study and randomly divided into observation group and control group.Patients in control group were treated with allopurinol,prednisone,benner pury and valsartan,while those in observation group were treated with urokinase,mycophenolate mofetil besides the basis of control group for 6 months.The blood uric acid （UA）,24 h urine protein,mean arterial pressure （MAP） and creatinine clearance rate （Ccr） were determined and analyzed.Results The levels of UA,24 h urinary protein,MAP and Ccr in observation group and control group were same before treatment （P 〉 0.05）.After 6 months treatment,the levels of UA,24 h urine protein,MAP and Ccr in observation group were （413.7 ± 90.7） μmol/L,（1.15 ± 0.57） g/L,（87.7 ± 10.6） mmHg and （81.9 ± 3.7） ml/min respectively,significantly different from those of the control group （（369.6 ± 67.2） μ mol/L,（0.77 ±0.51） g/L,（81.6 ±12.3） mmHg and （86.4 ±6.8） ml/min;t =2.219,2.802,2.132,3.230;P 〈0.05）.The rate of adverse reactions in two groups was not significantly differnent（9.7% （3/31） vs 9.1% （3/33） ; x^2 =0.006,P =0.936）.Conclusion Multiply target therapy is effective and safe in terms of treating chronic progressive moderate and severe IgA nephropathy with hyperuricemia.

关 键 词：高尿酸血症 IGA肾病 多靶点疗法 

分 类 号：R692.3[医药卫生—泌尿科学] R589.7[医药卫生—外科学]