氯沙坦钾治疗特发性膜性肾病对血清抗PLA2R抗体的影响  

Effects of Losartan Potassium on Serum Anti-PLA2R Antibody in Patients with Idiopathic Membranous Nephropathy

作　　者：方纪林 蒋红利 李向东[1] 李毅[1] 赵明[1] 沈海燕[1] 刘亚男 FANG Ji-lin;JIANG Hong-li;LI Xiang-dong;LI Yi;ZHAO Ming;SHENG Hai-yan;LIU Ya-nan(Department of Nephrology,Hanzhong 3201 Hospital,Xi'an Jiaotong University School of Medicine,Hanzhong,Shaanxi,723000,China;Department of Nephrology,Xi'an Jiaotong University,Xi'an,Shaanxi,710000,China)

机构地区：[1]西安交通大学医学院附属汉中3201医院肾病内科,陕西汉中723000 [2]西安交大医学院肾病内科,陕西西安710000

出　　处：《现代生物医学进展》2020年第9期1729-1732,共4页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81370838/H0511)。

摘　　要：目的:探讨氯沙坦钾治疗特发性膜性肾病对血清抗磷脂酶A2受体(Phospho lipase A2 receptor,PLA2R)抗体的影响。方法:2014年8月到2018年8月选择在西安交通大学医学院附属汉中3201医院(本院)肾内科诊治的特发性膜性肾病患者78例,根据随机数字表法分为两组,各39例,对照组给予常规腹膜透析治疗,观察组在对照组治疗的基础上给予氯沙坦钾治疗,两组都治疗观察3个月,记录血清抗PLA2R抗体表达变化。结果:观察组治疗的总有效率为100.0%,显著高于对照组的87.2%(P<0.05)。两组治疗后的血尿素氮(Blood urea nitrogen,BUN)、肌酐(Creatine,CREA)、尿酸(Uric acid,UA)值都低于治疗前,且观察组也显著低于对照组(P<0.05)。两组治疗后的血清超氧化物歧化酶(Superoxide Dismutase,SOD)、谷胱甘肽过氧化酶(Glutathione Peroxidase,GSH-Px)值都高于治疗前,丙二醛(Malonic dialodehyde,MDA)值低于治疗前,且观察组变化更加显著(P<0.05)。两组治疗后的血清抗PLA2R抗体表达水平显著低于治疗前(P<0.05),观察组也显著低于对照组(P<0.05)。结论:氯沙坦钾治疗特发性膜性肾病能抑制血清抗PLA2R抗体表达,调节氧化应激功能,从而促进肾功能的改善,提高患者的治疗效果。Objective:To investigate the effects of losartan potassium on serum phospholipase A2 receptor(PLA2R)antibody in patients with idiopathic membranous nephropathy.Methods:From August 2014 to August 2018,78 patients with idiopathic membranous nephropathy who were diagnosed and treated in the Department of Nephrology,Hanzhong 3201 Hospital of Xi'an Jiaotong University School of Medicine were equally divided into the observation group and control group accorded to the random number table.The control group was given conventional peritoneum dialysis treatment,and the observation group was treated with losartan potassium on the basis of the control group,and the two groups were treated for 3 months,and the serum anti-PLA2R antibody expression was recorded.Results:The total effective rates of the observation group was 100.0%,which was significantly higher than that of the control group(87.2%)(P<0.05).The BUN,CREA and UA values of the two groups after treatment were lower than those before treatment,and the observation group was also significantly lower than the control group(P<0.05).The levels of serum GSH-PX and SOD values of the two groups after treatment were higher than those before treatment,and the MDA values were lower than before treatment,and the changes in the observation group were more significant(P<0.05).The serum anti-PLA2R antibody expression levels in the two groups after treatment were significantly lower than that before treatment,and the observation group were also significantly lower than the control group(P<0.05).Conclusion:Losartan potassium treatment of idiopathic membranous nephropathy can inhibit the expression of anti-PLA2R antibody and regulate oxidative stress,thereby promote the improvement of renal function and improving the therapeutic effect of patients.

关 键 词：氯沙坦钾 特发性膜性肾病 磷脂酶A2受体 疗效 

分 类 号：R692.6[医药卫生—泌尿科学]