雷公藤多甙联合血管紧张素受体拮抗剂治疗中等量蛋白尿IgA肾病疗效研究  

Tripterygium wilfordii Hook F combined with angiotensin receptor blocker in the treatment of IgA nephropathy with moderate proteinuria

作　　者：朱林波[1] 王娟[1] 刘林林[1] 姚丽[1] 李子龙[1] 李艳秋[1] 范秋灵[1] 王力宁[1] 

机构地区：[1]中国医科大学附属第一医院肾内科,辽宁沈阳110001

出　　处：《中国实用内科杂志》2017年第6期549-551,共3页Chinese Journal of Practical Internal Medicine

基　　金：国家自然科学基金(81500525);辽宁省自然科学基金(2014021046)

摘　　要：目的比较雷公藤多甙联合血管紧张素受体拮抗剂(ARB)与单独应用ARB治疗中等量蛋白尿IgA肾病的疗效。方法纳入2014年1月至2015年12月期间于中国医科大学附属第一医院肾内科住院治疗的原发性IgA肾病患者,24 h尿蛋白定量为1.0~3.5 g,且肾功能正常,行雷公藤多甙联合ARB治疗者30例,同时选取同时期ARB单独治疗者30例为对照组。比较两组治疗前后临床指标以及两组间的临床缓解率。结果两组患者的一般临床病理特征比较差异无统计学意义。两组患者经6个月治疗后尿蛋白、血清白蛋白均明显改善(P均<0.05),肾功能稳定。联合治疗组临床缓解率明显高于ARB治疗组(P<0.05)。结论雷公藤多甙联合ARB能明显减少中等量蛋白尿IgA肾病患者的蛋白尿,改善血清白蛋白水平,稳定肾功能。Objective To compare the efficacy oftripterygium wilfordii Hook F （TwHF） combined with angiotensin receptor blocker （ARB） with that of only ARB in the treatment of IgA nehropathy with moderate proteinuria. Methods We included the patients with primary IgA nephropathy hospitalized in our hospital between Jan. 2014 and Dec. 2015, who had urinary protein excretions of 1-3.5g/d and normal renal function. Thirty patients were treated with TwHF combined with ARB, and we included randomly 30 patients treated with only ARB in the same period. The clinical parameters before and after treatment were compared within the groups, and the rates of clinical remission were compared between the two groups. Results The baseline clinical and pathological characteristics were not significantly different between the two groups. After 6-month treatment, the urinary protein excretion and serum albumin were improved significantly in the two groups （P values 〈0.05）, and renal fimction remained stable. The rate of clinical remission in the combination group was significantly higher than with only ARB （P 〈 0.05）. Conclusions TwHF combined with ARB can reduce urinary protein excretion, improve the levels ofserurn albumin, and stabilize renal function in IgA nephropathy patients with moderate proteinuria.

关 键 词：雷公藤多甙 血管紧张素受体拮抗剂 IGA肾病 

分 类 号：R692[医药卫生—泌尿科学]