沷尼松联合CTX治疗IgA肾病的疗效及影响因素分析  

The efficacy and influencing Factors of combination of Prednisone and MTX in patients with IgA nephropathy

作　　者：操轩[1] 陈健[1] 胡亚琳[1] 

机构地区：[1]湖北省黄石市中心医院肾内科,湖北黄石435000

出　　处：《海南医学院学报》2016年第1期48-50,共3页Journal of Hainan Medical University

基　　金：国家自然科学基金面上项目(30670985)~~

摘　　要：目的:探讨沷尼松联合环磷酰胺(CTX)治疗原发性免疫球蛋白A(IgA)肾病患者的疗效及影响因素。方法:选取本院收治的96例IgA肾病患者为研究对象,患者均行沷尼松联合CTX治疗,观察患者治疗效果及治疗前后肾功能指标的变化,并分析影响IgA肾病患者沷尼松联合CTX治疗效果的相关因素。结果:96例IgA肾病患者显效38例(39.58%),有效42例(43.75%),无效16例(16.67%),总有效率为80例(83.33%);患者治疗后尿素氮(BUN)、血肌酐(血Scr)、24h尿蛋白(24hUab)低于治疗前,而内生肌酐清除率(Ccr)水平明显高于治疗前,差异具有统计学意义(P<0.05);经Logistic多因素分析,24hUab、治疗前Ccr、LEE肾组织分级、合并高血压是影响沷尼松联合CTX治疗IgA肾病患者预后的危险因素。结论:沷尼松联合CTX是治疗IgA肾病有效的方案,但在选择该方案时,应充分考虑患者临床及病理特点。Objective： To evaluate the efficacy of prednisone combining with cyclophosphamide （CTX） on primary im- munoglobulin A （IgA） and its affecting factors. Methods： A total of 96 IgA nephropathy patients treated in our hospital were enrolled. All the patients were treated with prednisone combining with CTX. Renal functions before and after the treatment was measured and factors may affecting the effects were analyzed. Results： Among the 96 cases, 38 showed obvious effects （39.58%）, 42 cases showed effects （43. 75%）, 16 cases showed no curative effects （16. 67%） with a total efficiency of 83.33%（80/96）. After treatment, blood urea nitrogen （BUN）, serum creatinine （blood Scr）, 24 h urine protein （24 hUab） were lower than before treatment, but endogenous creatinine clearance （Ccr） were significantly higher than that before treatment （P〈0.05）. Logistic regression analysis showed that 24 h hUab level, Ccr level before treatment, LEE kidney tissue classification, occurrence of hypertension were risk factors affecting the treatment effects of prednisone combining with CTX on IgA nephropathy and patients＇ prognosis. Conclusion： Prednisone combining with CTX is effective on IgA nephropathy, hut patients＇ clinical and pathological features should be considered in application of this therapy.

关 键 词：沷尼松 环磷酰胺 IGA 肾病 

分 类 号：R692[医药卫生—泌尿科学]