不同剂量雷公藤多苷对慢性肾小球肾炎患者血清水平的影响  

Effects of different doses of tripterygium glycosides on serum LKN-1,RBP,MMP-9 and TIMP-1 in patients with chronic glomerulonephritis

作　　者：张琴[1,2] 尹罗娟 欧阳林旗[1] 杨磊[1,2] 胡炜航[1,2] 

机构地区：[1]湖南中医药大学第一附属医院,湖南长沙410007 [2]全国名老中医药专家张志国传承工作室,湖南长沙410007

出　　处：《西部医学》2018年第2期187-191,共5页Medical Journal of West China

基　　金：湖南省教育厅科研基金项目(14B132)

摘　　要：目的探讨不同剂量雷公藤多苷对慢性肾小球肾炎患者血清白细胞诱素-1(LKN-1)、视黄醇结合蛋白(RBP)、基质金属蛋白酶9(MMP-9)、金属蛋白酶组织抑制剂1(TIMP-1)的影响。方法选取2015年3月~2017年3月我院接诊的100例肾小球肾炎患者,随机数表法分为A组和B组,每组各50例,在常规治疗基础上,两组均给予雷公藤多苷片治疗,A组先以1.5mg/kg·d的剂量服用4周,之后以1mg/kg·d的剂量再服用4周;B组剂量为1mg/kg·d,连续用药8周。比较两组治疗前后肌酐(sCr)、尿素氮(BUN)、24小时尿蛋白定量以及血清LKN-1、RBP、MMP-9、TIMP-1的变化,并比较临床疗效及不良反应。结果治疗后,两组SCr、BUN、24小时尿蛋白定量较治疗前均得到明显降低(P<0.05),A组SCr、BUN、24小时尿蛋白定量明显低于B组(P<0.05);治疗后,两组血清LKN-1、RBP、TIMP-1较治疗前明显降低,血清MMP-9明显增加(P<0.05),A组血清LKN-1、RBP、TIMP-1明显低于B组,血清MMP-9明显高于B组(P<0.05);A组临床疗效总有效率明显高于B组(P<0.05);两组不良反应发生率无显著差异(P>0.05)。结论慢性肾小球肾炎患者中,增加雷公藤多苷的起始剂量更有助于改善肾功能、提高临床疗效,其内在机制可能更有效的降低血清LKN-1、RBP水平,增加MMP-9活性,抑制TIMP-1的表达相关,且并未增加药物不良反应,用药安全性高。Objective To study effects of different doses of tripterygium glycosides on serum leukotactin-1（LKN- 1）, retinol binding protein （RBP）, matrix metalloproteinases-9 （MMP-9） and tissue inhibitor of metalloproteinase 1 （TIMP-1） in patients with chronic glomerulonephritis. Methods 100 patients of chronic glomerulonephritis received therapy from March 2015 to March 2017 in our hospital were selected. According to random number table, those patients were divided into the A group （n= 50） and the B group （n= 50）. On the basis of conventional treatment, the two groups were treated with Tripterygium Glycosides tablets. A group was given 1.5mg/ （kg. d） for 4 weeks, then take the ling/ （kg. d） for another 4 weeks. B group was given lmg/ （kg. d）. The changes of creatinine （sCr）, urea nitrogen （BUN） and 24 h urinary protein and serum LKN-1, RBP, MMP-9 and TIMP-] were compared between the two groups before and after treatment. The clinical efficacy and adverse reactions were compared. Results After treatment, SCr, BUN and 24 h urine protein in the two groups were significantly lower than those before treatment （P〈0.05）. SCr, BUN and 24 h urine protein in the A group were significantly lower than that of the B group（P〈0.05）. After treatment, serum LKN-1, RBP and TIMP-1 in the two groups were significantly lower than those before treatment. The serum MMP-9 increased significantly（P〈0.05）. The serum LKN-1, RBP and TIMP-1 in A group were significantly lower than that of the B group, and serum MMP-9 was significantly higher than that of the B group （P〈0. 05）. The total effective rate in the A group was significantly higher than that of B group（P〈0.05）. There was no significant difference in the incidence of adverse reactions between the two groups（P〉0.05）. Conclusion In patients with chronic glomerulonephritis, increase the initial dose of tripterygium glycosides is more helpful to improve renal function and clinical efficacy. The underlying mechanism ma

关 键 词：慢性肾小球肾炎 雷公藤多苷 肾功能 血清水平 

分 类 号：R692.31[医药卫生—泌尿科学]