贝前列素钠联合免疫抑制剂治疗肾病综合征患者效果及对血清β2-微球蛋白、凝血指标、纤溶指标影响  

Effects of Beraprost Sodium Combined with Immunosuppressive Agents in the Treatment of Nephrotic Syndrome and Their Influence on Serumβ2 Microglobulin,Coagulation Indexes and Fibrinolytic Indexes

作　　者：王波 肖健[1] 刘正萌 杨小华[1] WANG Bo;XIAO Jian;LIU Zheng-meng;YANG Xiao-hua(Department of Nephrology,Guangyuan Central Hospital,Guangyuan,Sichuan 628017,China)

机构地区：[1]广元市中心医院肾内科,四川广元628017

出　　处：《临床误诊误治》2020年第8期40-45,共6页Clinical Misdiagnosis & Mistherapy

基　　金：四川省科技厅科技支撑计划基金资助项目(2014SZ13716)。

摘　　要：目的探讨贝前列素钠联合免疫抑制剂治疗肾病综合征(nephrotic syndrome,NS)患者的效果及对血清β2-微球蛋白(β2-MG)、凝血指标、纤溶指标的影响。方法选取符合纳入及排除标准的NS 116例,根据治疗方法不同将其分为观察组和对照组两组各58例。观察组采用贝前列素钠联合醋酸泼尼松治疗,对照组仅采用醋酸泼尼松治疗,均连续治疗6个月。观察比较两组治疗后临床效果,治疗前后血清β2-MG、肾功能指标、血脂、凝血指标及纤溶指标水平,以及治疗期间不良反应发生情况。结果治疗后,观察组总缓解率高于对照组,差异有统计学意义(P<0.01)。治疗前,两组血清β2-MG、肾功能指标、血脂、凝血指标及纤溶指标水平比较差异无统计学意义(P>0.05)。治疗后,两组血清β2-MG、尿素(BUN)、肌酐(Cr)、内生肌酐清除率(Ccr)、总胆固醇(TC)、甘油三酯(TG)、纤维蛋白原(FIB)、D-二聚体(D-D)水平及24 h尿蛋白均低于治疗前,血清白蛋白(Alb)水平及凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、抗凝血酶Ⅲ(ATⅢ)均高于或长于治疗前,差异有统计学意义(P<0.05或P<0.01)。治疗后,观察组血清β2-MG、BUN、Cr、Ccr、TC、TG、FIB、D-D水平及24 h尿蛋白低于对照组,血清Alb水平及PT、APTT、ATⅢ高于或长于对照组,差异有统计学意义(P<0.05或P<0.01)。治疗期间,两组总不良反应发生率比较差异无统计学意义(P>0.05)。结论贝前列素钠联合免疫抑制剂治疗NS患者可以提高总缓解率,降低血清β2-MG水平,改善肾功能及血液高凝状态。Objective To investigate the effects of Beraprost sodium combined with immunosuppressive agents in the treatment of nephrotic syndrome(NS)and their influence on serum β2 microglobulin(β2-MG),coagulation indexes and fibrinolytic indexes.Methods A total of 116 patients with NS were divided into the observation group and the control group according to different treatment methods,with 58 patients in each group.The observation group was treated with Beraprost sodium combined with Prednisone acetate and the control group was treated with Prednisone acetate alone.Both groups were treated for 6 months.The clinical effects after treatment,levels of serum β2-MG,renal function indexes,blood lipids,coagulation indexes and fibrinolytic indexes before and after treatment,and the incidence of adverse reactions during treatment were compared between the two groups.Results After treatment,the overall remission rate was significantly higher in the observation group than in the control group(P<0.01).Before treatment,there was no significant difference in serum β2-MG,renal function indexes,blood lipids,coagulation indexes or fibrinolytic indexes between the two groups(P>0.05).After treatment,levels of serum β2-MG,blood urea nitrogen(BUN),creatinine(Cr),endogenous creatinine clearance rate(Ccr),total cholesterol(TC),triglyceride(TG),fibrinogen(FIB)and D-dimer(D-D)and 24-hour urine protein quantitation in the two groups were lower than those before treatment.Serum albumin(Alb),prothrombin time(PT),activated partial thromboplastin time(APTT)and antithrombin Ⅲ(ATⅢ)were higher or longer than those before treatment(P<0.05 or P<0.01).After treatment,the levels of serum β2-MG,BUN,Cr,Ccr,TC,TG,FIB,D-D and 24-hour urine protein quantitation in the observation group were lower than those in the control group,while the levels of serum Alb,PT,APTT and ATⅢ were higher or longer than the control group(P<0.05 or P<0.01).During treatment,there was no significant difference in the overall incidence of adverse reactions between the two gro

关 键 词：贝前列素钠 免疫抑制剂 肾病综合征 β2-微球蛋白 凝血指标 纤溶指标 

分 类 号：R692[医药卫生—泌尿科学]