厄沙贝坦联合活性维生素D对IgA肾病患者免疫功能及TGF-β1和sTfR表达的影响  

Effect of Irbesartan combined with activated vitamin D on immune function and expression of TGF-β1,sTfR in patients with IgA nephropathy

作　　者：张鹏[1] 何晓东[1] 陈望[1] ZHANG Peng;HE Xiao-dong;CHEN Wang(Department of Nephrology, The Fourth People's Hospital of Shenyang, Shenyang Liaoning 110031, China)

机构地区：[1]沈阳市第四人民医院干诊肾内科,辽宁沈阳110031

出　　处：《临床和实验医学杂志》2018年第5期495-499,共5页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨厄沙贝坦联合活性维生素D对IgA肾病患者免疫功能及转化生长因子-β1(TGF-β1)和血清转铁蛋白受体(sTfR)表达的影响。方法前瞻性选取2013年1月至2016年1月间的60例IgA肾病患者为研究对象,根据随机数字表法分为三组,分别为厄沙贝坦组、活性维生素D组及厄沙贝坦联合活性维生素D组,每组20例。厄贝沙坦组给予厄贝沙坦片,活性维生素D组给予骨化三醇胶丸,厄沙贝坦联合活性维生素D组给予厄贝沙坦片和骨化三醇胶丸。比较三组患者的临床疗效,治疗前后的免疫功能及TGF-β1、sTfR表达水平,观察各组不良反应情况。结果厄沙贝坦联合活性维生素D组(90.00%)的总有效率显著高于厄沙贝坦组(75.00%)和活性维生素D组(55.00%),差异具有统计学意义(P<0.05)。治疗后,三组患者的尿蛋白含量较治疗前降低,且厄沙贝坦联合活性维生素D组显著低于厄沙贝坦组和活性维生素D组,差异具有统计学意义(P<0.05)。治疗后,厄沙贝坦联合活性维生素D组的CD4^+、CD4^+/CD8^+较治疗前均显著降低,差异具有统计学意义(P<0.05),厄沙贝坦联合活性维生素D组的CD4^+、CD4^+/CD8^+低于厄沙贝坦组和活性维生素D组,但三组间CD4^+、CD8^+及CD4^+/CD8^+比较,差异均无统计学意义(P>0.05)。治疗后,厄沙贝坦联合活性维生素D组的尿液s TfR、血清TGF-β1、尿液TGF-β1水平较治疗前均显著降低,差异具有统计学意义(P<0.05),厄沙贝坦联合活性维生素D组的血清s TfR、尿液s TfR、血清TGF-β1、尿液TGF-β1低于厄沙贝坦组和活性维生素D组,但三组间比较,差异无统计学意义(P>0.05)。三组患者均无严重不良反应,差异无统计学意义(P>0.05)。结论厄沙贝坦联合活性维生素D对于治疗IgA肾病具有良好疗效,能够降低患者的尿蛋白含量,降低TGF-β1、sTfR的表达水平,改善免疫功能,值得临床推广应用。Objective To discuss the effect of Irbesartan combined with activated vitamin D on immune function and expression of TGF-β1,sTfR in patients with IgA nephropathy.Methods From January2013to January2016,60patients with IgA nephropathy were selected for this study in our hospital and the patients were divided into three groups,Irbesartan group,activated vitamin D group and Irbesartan combined with activated vitamin D group,20cases in each group.The Irbesartan group was treated with Irbesartan,activated vitamin D group was treated with activated vitamin D,and Ibesartan combined with activated vitamin D group was treated with Irbesartan combined with activated vitamin D.The curative effect,immune function and expression of TGF-β1,sTfR of three groups were compared before and after treatment.Results The total effective rate(90.00%)of Ibesartan combined with activated vitamin D group was significantly higher than Irbesartan group(75.00%)and activated vitamin D group(55.00%),difference was statistically significant(P<0.05).After treatment,the urine protein content of three groups were reduced,the Ibesartan combined with activated vitamin D group was significantly lower than Irbesartan group and activated vitamin D group(P<0.05).After treatment,the CD4+,CD4+/CD8+of Irbesartan combined with activated vitamin D group were significantly reduced than before(P<0.05),but the CD4+;CD8+and CD4+/CD8+of three groups had no statistically significant difference(P>0.05).After treatment,the urine sTfR,serum TGF-β1,urine TGF-β1of Ibesartan combined with activated vitamin D group were significantly reduced than before(P<0.05),but the serum sTfR,urine sTfR,serum TGF-β1,urine TGF-β1of three groups were no statistically significant difference(P>0.05).The adverse reaction of three groups had no statistically significant difference(P>0.05).Conclusion The application of Irbesartan combined with activated vitamin D is effective for the patients with IgA nephropathy and it can reduce the urine protein content,reduce the expression of TGF-�

关 键 词：IGA肾病 厄沙贝坦 活性维生素D 免疫功能 转化生长因子-Β1 血清转铁蛋白受体 

分 类 号：R692.31[医药卫生—泌尿科学]