环孢素A与吗替麦考酚酯对微小病变型肾病患儿血浆可溶性尿激酶型纤溶酶原激活物受体水平的影响  

Effect of cyclosporin A and mycophenolate mofetil on levels of soluble urokinase type plasminogen activator receptor in children patients with minimal change disease

作　　者：王凯臣[1] 张赟[1] 刘恒昌[2] 晋学飞[1] 

机构地区：[1]吉林大学中日联谊医院泌尿外科,长春130021 [2]吉林大学第一医院胃结直肠外科

出　　处：《中华实验外科杂志》2015年第9期2279-2282,共4页Chinese Journal of Experimental Surgery

摘　　要：目的 观察环孢素A（CsA）与吗替麦考酚酯（MMF）对微小病变型肾病（MCD）患儿血浆中可溶性尿激酶型纤溶酶原激活物受体（suPAR）水平变化的影响,及探讨suPAR在微小病变型肾病中的作用.方法 将29例MCD患儿随机分为CsA组（A组）和MMF组（B组）,分别给予CsA和MMF联合强的松治疗12个月,采用酶联免疫吸附试验法（ELISA）检测治疗前后血浆中suPAR水平,并对患儿进行至少12个月的门诊随访,观察治疗效果.结果 治疗12个月后,B组血浆suPAR水平为（2 208.3±395.4） ng/L,较治疗前下降,A组为（2984.6±804.7）ng/L较治疗前上升,且显著高于B组（P＜0.05）;两组患儿治疗后尿蛋白和24h尿蛋白均较治疗前显著降低（P＜0.05）,但组间差异无统计学意义（P＞0.05）;A组治疗后肾小球滤过率（GFR）较治疗前显著下降,B组显著升高,且显著高于A组（P＜0.05）;A组不良反应发生率为57.14％ （8/14）,总缓解率为85.71％（12/14）,复发率为14.29％（2/14）,B组不良反应发生率为35.71％ （5/14）,总缓解率为78.57％（11/14）,复发率为35.71％ （5/14）,两组差异无统计学意义（P＞0.05）.结论 CsA和MMF对MCD患儿的治疗效果较好,两者对血浆中suPAR水平和GFR起相反作用,但对于尿蛋白和24h尿蛋白无明显影响.Objective To observe the level change of soluble urokinase type plasminogen activator receptor （suPAR） in the plasma of children with minimal change disease （MCD） caused by cyclosporin A （CsA） and mycophenolate mofetil （MMF） and investigate the role of suPAR in minimal change disease.Methods The 29 children with MCD were divided into two groups：CsA group （group A） and MMF group （group B）,given CsA and MMF combined with prednisone for 12 months respectively.The plasma level of suPAR was determined by enzyme linked immunosorbent assay （ELISA）.These children were followed up for at least 12 months to observe the curative effectiveness.Results After treatment for 12 months,suPAR levels in group B [（2 208.3 ±395.4） ng/L] were lower than those before treatment,and those in group A were significantly increased [（2 984.6 ± 804.7） ng/L],significantly higher than in group B （P ＜0.05）.The urinary protein and 24-h urine protein after treatment in the two groups were significantly reduced as compared with those before treatment （P ＜ 0.05）,but there were no significant differences between two groups （P ＞0.05）.The incidence of adverse reactions in group A was 57.14％ （8/14）,the total response rate was 85.71％ （12/14）,and the recurrence rate was 14.29％ （2/14）,and those in group B were 35.71％ （5/14）,78.57％ （11/14）,and 35.71％ （5/14） respectively,with the difference being not significant between two groups.Conclusion The curative efficacy of CsA and MMF on MCD was good.Both CsA and MMF had the opposite effect on suPAR and GFR,but had no significant effect on urinary protein and 24-h urine protein.

关 键 词：微小病变性肾病 可溶性尿激酶型纤溶酶原激活物受体 环孢素A 吗替麦考酚酯 

分 类 号：R735[医药卫生—肿瘤]