福辛普利联合缬沙坦治疗IgA肾病患儿的疗效及其对尿TGF-β1水平的影响  

Effects of fosinopril and valsartan on clinical role and its influence on urine TGFβ1 level in Ig A nephropathy children

作　　者：王云[1] 徐达良[1] 董扬[1] 朱颖[1] 江家云[1] 汪海涛[1] 方韶晗 

机构地区：[1]安徽医科大学儿科临床学院,安徽省儿童医院肾内科,合肥230051

出　　处：《安徽医学》2015年第4期406-409,共4页Anhui Medical Journal

基　　金：安徽省卫生厅医学科研项目(2010B028)

摘　　要：目的观察应用福辛普利联合缬沙坦治疗Ig A肾病患儿的临床疗效以及其对尿转化生长因子β1(TGF-β1)水平的影响,探讨其保护肾脏的可能机制。方法 30例Ig A肾病患儿知情同意后被随机分为治疗组和对照组各15例;对照组在综合治疗(按分级标准及临床表现给予包括糖皮质激素、双嘧达莫等)基础上加福辛普利治疗,治疗组在对照组治疗方法的基础上加用缬沙坦,随访终点为6个月;分别于治疗前、治疗后15天、1个月、3个月、6个月检测24 h尿蛋白定量,同时检测尿TGF-β1水平。结果1治疗后15天,两组分别与治疗前比较,24 h尿蛋白定量及尿TGF-β1含量均无下降。2治疗后1个月,对照组与治疗前比较,24 h尿蛋白定量及尿TGF-β1含量下降,但差异无统计学意义(P>0.05);治疗组与治疗前比较,24 h尿蛋白定量下降明显,差异有统计学意义(P<0.05),尿TGF-β1含量虽有下降,但差异无统计学意义(P>0.05)。3治疗后3个月,两组与治疗前比较,24 h尿蛋白定量及尿TGF-β1含量均有明显下降(P<0.05),且治疗组较对照组下降更显著(P<0.05)。4治疗后6个月,两组与治疗前比较,24 h尿蛋白定量与尿TGF-β1含量均有明显下降(P<0.05),且治疗组较对照组下降更显著;但与同组3个月比较,仅24 h尿蛋白定量的下降差异有统计学意义(P<0.05)。结论福辛普利联合缬沙坦有较好的降低Ig A肾病患儿尿蛋白的作用,可能与其早期改善肾纤维化作用有关。Objective To observe the effects of fosinopril and valsartan on clinical role and TGFβ1 in IgA nephropathy children and to explore their renoprotective mechanism. Methods 30 cases of patients with IgA nephropathy after informed consent were randomly dividedinto a treatment group and a control group(n=15);Clinical commonly used method is used for the control group(including the adrenal glu-cocorticoids,dipyridamole and fosinopril were given according to the classification standard and clinical manifestations). The treatment group on the basis of the control group was treated with valsartan,end of follow-up was 6 months,respectively before and after treatment of 15 days, 1 month,3 months,6 months to detect 24 hours urine protein,at the same time collecting urine to detect protein and TGF-beta1 level. Re-sults ①After treatment of 15 days,content of urine protein and urine TGF-quantitative beta 1 in both groups respectively compared with be-fore treatment have not decreased at all.②After one month,the control group compared with before treatment,urine protein and urinary quan-titative TGF-there is a decrease in the content of beta 1,but there was no statistically significant difference(P>0. 05);Treatment group com-pared with before treatment,urine protein quantitative declined,the difference was statistically significant(P<0. 05),the urine TGF-beta 1 levels have fallen,but no statistical significance(P>0. 05).③The treatment for 3 month,compared with before treatment in both groups, quantitative urine protein and urine TGF-beta 1 levels have significantly decreased(P<0. 05),and the treatment group decreased more signif-icantly than the control group.④six month,compared with before treatment in both groups,quantitative urine protein and urine TGF-beta 1 levels have significantly decreased(P<0. 05),and the treatment group than the control group decreased more obvious;Compared with treat-ment for 3 month,but only the urine protein quantitative have significantly lowered,the difference was statistically significa

关 键 词：福辛普利 缬沙坦 IgA肾病 转化生长因子Β1 

分 类 号：R726.9[医药卫生—儿科]