贝前列素钠联合免疫抑制剂治疗原发性肾病综合征的疗效和安全性评价  

Efficacy and evaluation on safety of beraprost sodium combined with immunosuppressor in treatment of primary nephrotic syndrome

作　　者：王雪婷[1,2] 周广宇 王艺璇[1] 郭莹[1] 尹敏[1] 吴晨[1] WANG Xueting;ZHOU Guangyu;WANG Yixuan;GUO Ying;YIN Min;WU Chen(Department of Nephrology,China-Japan Union Hospital,Jilin University,Changchun 130033,China;Department of Nephrology,People’s Hospital,Changchun City,Jilin Province,Changchun 130051,China)

机构地区：[1]吉林大学中日联谊医院肾内科,吉林长春130033 [2]吉林省长春市人民医院肾内科,吉林长春130051

出　　处：《吉林大学学报（医学版）》2018年第6期1291-1297,共7页Journal of Jilin University：Medicine Edition

基　　金：国家自然科学基金面上项目资助课题(81370810);吉林省科技厅自然科学基金资助课题(20160101059JC);吉林大学中日联谊医院横向课题资助课题(2017YX301)

摘　　要：目的:探讨贝前列素钠(BPS)联合糖皮质激素(GC)和(或)免疫抑制剂治疗原发性肾病综合征(PNS)患者的临床疗效和安全性,为其应用于PNS的治疗提供依据。方法:选取明确诊断为PNS的患者86例,所有患者均应用GC和(或)免疫抑制剂治疗,根据患者意愿选择不同的抗血小板治疗方案,分为应用BPS的BPS组(n=42)和应用双嘧达莫或阿司匹林的对照组(n=44)。分析2组患者治疗前后相关实验室指标的差异,并比较2组患者治疗有效率、并发症和药物不良反应发生率。结果:与对照组比较,治疗1和6个月时BPS组患者尿蛋白水平明显降低(P<0.05),血清白蛋白(ALB)水平明显升高(P<0.05);治疗3、6和12个月时,BPS组患者纤维蛋白原(FIB)水平和D-二聚体(DD)水平明显降低(P<0.05或P<0.01)。与对照组比较,治疗1个月时BPS组患者收缩压(SBP)和舒张压(DBP)明显降低(P<0.05)。治疗6个月时BPS组患者总有效率和总胆固醇(TC)水平高于对照组(P<0.05)。与对照组比较,BPS组中基础血压正常患者血压升高发生率明显降低(P<0.05),头晕和头痛发生率明显升高(P<0.05)。结论:BPS联合GC和(或)免疫抑制剂治疗PNS患者安全性较高,优于传统抗血小板药物。Objective:To explore the clinical efficacy and safety of beraprost sodium(BPS)combined with glucocorticoid(GC)and(or)immunosuppressive agents in the treatment of the patients with primary nephrotic syndrome(PNS),and to provide evidence for its application in the treatment of PNS.Methods:Eighty-six patients diagnosed as PNS definitely were selected.They were treated with GC and(or)immunosuppressive agents and were divided into BPS group(administrated with BPS,n=42)and control group(administrated with dipyridamole or aspirin,n=44)according to their willing to the acceptance of different anti-platelet treatment regimens.The relevant laboratory indexes of the patients in two groups before and after treatment were analyzed,and the effective rate,incidence of complications and drug adverse reactions of the patients in two groups were compared.Results:Compared with control group,the urinary protein levels of the patients in BPS group at the 1st and 6th months after treatment were significantly decresed(P<0.05)and the serum albumin(ALB)levels of the patients in BPS group were significantly increased(P<0.05);the levels of fibrinogen(FIB)and D-dimer(DD)of the patients in BPS group at the 3rd,6th and 12th months after treatment were significantly decreased(P<0.05 or P<0.01).Compared with control group,the systolic blood pressure(SBP)and diastolic blood pressure(DBP)of the patients i n BPS group at the 1st month after treatment were decreased significantly(P<0.05).The cholesterol(TC)level and total effective rate of the patients in BPS group at the 6th month after treatment were higher than those in control group(P<0.05).Compared with control group,the incidence of elevation of blood pressure of the patients with normal basal blood pressure in BPS group was significantly decreased(P<0.05);the incidence of headache and dizziness was significantly increased(P<0.05).Conclusion:The safety of BPS combined with GC and(or)immunosuppressive agents in treating the PNS patients is higher and superior to the conventional antip

关 键 词：原发性肾病综合征 贝前列素钠 糖皮质激素 免疫抑制剂 

分 类 号：R692.6[医药卫生—泌尿科学]