雷公藤多苷联合他克莫司治疗特发性膜性肾病的疗效及对尿C5b-9 IgG4的影响  

Efficacy of Tripterygium Wilfordii Polyglycoside Combined with Taprolimus in the Treatment of Idiopathic Membranous Nephropathy and its Effect on Urinary C5b-9 and IgG4

作　　者：梁衍[1] 闫晓辉[1] 王小明 金刚[1] 冯婷[1] LIANG Yan;YAN Xiaohui;WANG Xiaoming(Shaanxi People's Hospital, Shaanxi Xi'an 710068, China)

机构地区：[1]陕西省人民医院肾病血透中心

出　　处：《河北医学》2020年第2期211-215,共5页Hebei Medicine

基　　金：陕西省科学技术研究发展计划项目，(编号:2013KH12-20-17)

摘　　要：目的:研究雷公藤多苷联合他克莫司治疗特发性膜性肾病的疗效及对尿中攻膜复合物(C5b-9)、免疫球蛋白G4(IgG4)的影响。方法:选取2015年2月至2016年1月我院收治的92例特发性膜性肾病患者,根据患者入院顺序分为观察组和对照组,46例每组。对照组在常规治疗基础上加以他克莫司,观察组在对照组治疗基础上加以雷公藤多苷。比较两组患者临床疗效,肾功能指标,尿C5b-9、IgG4指标,性激素水平。结果:治疗后,观察组临床总有效率显著高于对照组[93.48%(43/46)比71.27%(33/46)](P<0.05)。观察组的血清白蛋白水平显著高于对照组[(34.21±3.87)g比(24.25±2.42)g](P<0.05),24h尿蛋白定量水平显著低于对照组[(1.15±0.17)g比(2.34±0.21)g](P<0.05)。观察组的尿C5b、IgG4水平显著低于对照组[(45.98±4.32)ng/mg、(65.21±6.54)ug/mmoL比(1.46±0.21)ng/mg、(6.32±0.69)ug/mmoL](P<0.05)。观察组的SBG、E2、T水平显著高于对照组[(37.54±3.14)nmoL/L、(42.16±4.45)pg/mL、(350.54±35.98)ng/dL比(26.98±2.87)nmoL/L、(35.87±3.76)pg/mL、(287.43±23.76)ng/dL](P<0.05),FSH水平显著低于对照组[(6.12±0.65)mIU/mL比(7.48±0.79)mIU/mL](P<0.05)。结论:雷公藤多苷联合他克莫司治疗特发性膜性肾病患者,能有效降低患者尿C5b-9、IgG4水平,对性激素水平的影响较小,临床疗效良好。Objective:To study the efficacy of tripterygium wilfordii polyglycoside combined with taprolimus in the treatment of idiopathic membranous nephropathy and its effect on urinary Urinary membrane attack complex(c5b-9),immunoglobulin G4(IgG4).Methods:From Februny 2015 to January 2016,92 patients with idiopathic membranous nephropathy were divided into observation group and control group according to the order of admission.The control group was treated with tacrolimus on the basis of conventional therapy.The observation group was treated with tripterygium glycosides on the basis of the control group.The clinical efficacy,renal function,urinary C5b-9,IgG4 and sex hormone levels were compared between the two groups.Results:After treatment,the total effective rate of the observation group was significantly higher than that of the control group[93.48%(43/46)vs 71.27%(33/46)](P<0.05).The level of serum albumin in the observation group was significantly higher than that in the control group[(34.21±3.87)g vs(24.25±2.42)g](P<0.05),and the 24h urine protein level was significantly lower than that in the control group[(1.15±0.17)g vs(2.34±0.21)g](P<0.05).The levels of urinary C5b and IgG4 in the observation group were significantly lower than those in the control group[(45.98±4.32)ng/mg,(65.21±6.54)ug/mmoL vs(1.46±0.21)ng/mg,(6.32±0.69)ug/mmoL](P<0.05).The levels of SBG,E2 and T in the observation group were significantly higher than those in the control group[(37.54±3.14) nmoL/L,(42.16±4.45)pg/mL,(350.54±35.98)ng/dL vs(26.98±2.87)nmoL/L(35.87±3.76)pg/mL,(287.43±23.76)ng/dL](P<0.05),FSH level was significantly lower than that of the control group[(6.12±0.65)mIU/mL vs(7.48±0.79)mIU/mL](P<0.05).Conclusion:Tacrolimus combined with tripterygium wilfordii polyglycoside can be used to treat patients with idiopathic membranous nephropathy,which can effectively reduce the levels of urinary C5b-9 and IgG4,and have little effect on sex hormone levels and good clinical curative effect.

关 键 词：特发性膜性肾病 他克莫司 雷公藤多苷 

分 类 号：R69[医药卫生—泌尿科学]