环磷酰胺联合糖皮质激素对原发性肾病综合征患者肾功能的影响  

Effects of Cyclophosphamide combined with Glucocorticoid on Renal Function in Patients with Primary Nephrotic Syndrome

作　　者：冯威 FENG Wei(Department of Nephrology,Fukuang General Hospital,Liaoning Health Industry Group,Fushun 113005,China)

机构地区：[1]辽宁省健康产业集团抚矿总医院肾内科,辽宁抚顺113005

出　　处：《中国医药指南》2020年第14期109-110,共2页Guide of China Medicine

摘　　要：目的探讨环磷酰胺(CTX)联合糖皮质激素对原发性肾病综合征(NS)患者肾功能的影响。方法将2017年2月至2018年9月76例原发性肾病综合征患者随机分为两组各38例,其中一组单用泼尼松治疗,另一组采用CTX与糖皮质激素联合治疗,分别设为对照组与CTX组。比较两组尿蛋白阴转时间、血白蛋白、胆固醇变化及血肌酐(Scr)、尿素氮(BUN)变化。结果CTX组尿蛋白阴转时间明显少于对照组(P<0.05)。两组治疗后1周的血白蛋白、胆固醇与基线比较无明显差异(P>0.05),治疗4周、12周的血白蛋白、胆固醇较基线明显改善(P<0.05),且CTX组改善明显优于对照组(P<0.05)。两组治疗1周、4周、12周的Scr、BUN水平与基线比较无明显差异(P>0.05)。结论CTX联合糖皮质激素治疗原发性NS,可有效增加血白蛋白,降低胆固醇,促进尿蛋白阴转,保护肾功能,效果优于糖皮质激素单一治疗。Objective To investigate the effect of cyclophosphamide(CTX)combined with glucocorticoid on renal function in patients with primary nephrotic syndrome(NS).Methods 76 patients with primary nephrotic syndrome from February 2017 to September 2018 were randomly divided into two groups,38 cases in each group.One group were treated with glucocorticoid alone,and the other group were treated with CTX combined with glucocorticoid,which was set as control group and CTX group,respectively.The urinary protein negative rotation time and changes of serum albumin,cholesterol,serum creatinine(Scr)and urea nitrogen(BUN)were compared between the two groups.Results The negative rotation time of urinary protein in the CTX group was significantly less than that in the control group(P<0.05).There were no significant difference in serum albumin and cholesterol between the two groups at 1 week after treatment(P>0.05),while serum albumin and cholesterol were significantly improved at 4 and 12 weeks after treatment(P<0.05),and the improvement in CTX group were significantly better than those in the control group(P<0.05).There were no significant difference in Scr and BUN levels between the two groups treated for 1 week,4 weeks and 12 weeks(P>0.05).Conclusion CTX combined with glucocorticoid in the treatment of primary NS can effectively increase blood albumin,reduce cholesterol,promote the negative conversion of urinary protein and protect renal function,and the effect is better than that of glucocorticoid monotherapy.

关 键 词：环磷酰胺 糖皮质激素 原发性肾病综合征 肾功能 

分 类 号：R692.5[医药卫生—泌尿科学]