扶正益肾汤联合糖皮质激素对肾病综合征sPD-1、sPD-L1水平的影响  

Effect of Fuzheng Yishen Tang Combined with Glucocorticoid for Nephrotic Syndrome on Levels of SPD-1 and SPD-L1

作　　者：刘建吉[1] 惠艳妮[1] 高政涛 LIU Jianji;HUI Yanni;GAO Zhengtao

机构地区：[1]濮阳市人民医院中医科,河南濮阳457000

出　　处：《新中医》2021年第9期35-39,共5页New Chinese Medicine

摘　　要：目的:观察扶正益肾汤联合糖皮质激素治疗对肾病综合征患者外周血中可溶性程序性死亡蛋白-1(sPD-1)和可溶性程序性死亡蛋白配体-1(sPD-L1)水平的影响。方法:选取142例原发性肾病综合征患者,按照随机数字表法分为观察组和对照组各71例。对照组予常规糖皮质激素治疗,观察组在对照组治疗基础上加用扶正益肾汤。治疗8周后,对比2组临床疗效及治疗前后血清sPD-1、sPD-L1、血肌酐(SCr)、血尿素氮(BUN)、肌酐清除率(CCr)、白蛋白(Alb)、内皮素-1(ET-1)、高迁移率族蛋白-1(HMGB-1)水平及24 h尿蛋白定量(24 hUpro),并分析2组不良反应发生情况。结果:治疗8周后,观察组总有效率为92.96%,显著高于对照组的78.87%(P<0.05)。与同组治疗前比较,2组治疗后血清sPD-1、sPD-L1、SCr、BUN、ET-1、HMGB-1及24 hUpro均降低(P<0.05),血清CCr、Alb均升高(P<0.05);与对照组治疗后比较,观察组治疗后血清sPD-1、sPD-L1、SCr、BUN、ET-1、HMGB-1及24 hUpro均较低(P<0.05),血清CCr、Alb均较高(P<0.05)。2组治疗期间均未出现严重不良反应。结论:扶正益肾汤联合糖皮质激素治疗肾病综合征临床疗效确切,安全性较好,能有效减轻患者炎症反应,下调sPD-1、sPD-L1水平,改善肾功能。Objective:To observe the effect of Fuzheng Yishen tang combined with glucocorticoid on the levels of soluble programmed death protein-1(sPD-1)and soluble programmed death protein ligand-1(sPD-L1)in peripheral blood of patients with nephrotic syndrome.Methods:A total of 142 cases of patients with primary nephrotic syndrome were selected and divided into the observation group and the control group according to the random number table method,71 cases in each group.The control group was routinely treated with glucocorticoid,and the observation group was additionally treated with Fuzheng Yishen tang based on the treatment of the control group.After eight weeks of treatment,the levels of sPD-1,sPD-L1,serum creatinine(SCr),blood urea nitrogen(BUN),creatinine clearance rate(CCr),albumin(Alb),endothelin-1(ET-1),high mobility group box protein-1(HMGB-1)in serum and the 24 h urinary protein quantification(24 hUpro)before and after treatment as well as the clinical effect in the two groups were compared;the incidence of adverse reactions in the two groups was analyzed.Results:After eight weeks of treatment,the total effective rate was 92.96%in the observation group,significantly higher than that of 78.87%in the control group(P<0.05).After treatment,sPD-1,sPD-L1,SCr,BUN,ET-1,HMGB-1 and 24 hUpro in serum in the two groups were decreased when compared with those before treatment(P<0.05),and CCr and Alb in serum were increased(P<0.05).After treatment,sPD-1,sPD-L1,SCr,BUN,ET-1,HMGB-1 and 24 hUpro in serum in the observation group were lower than those in the control group(P<0.05),and CCr and Alb in serum were higher(P<0.05).During treatment,no serious adverse reactions occurred in the two groups.Conclusions:The therapy of Fuzheng Yishen tang combined with glucocorticoid has definite clinical effect in treating nephrotic syndrome with good safety,which can effectively reduce the inflammatory reactions of patients,down-regulate the levels of sPD-1 and sPD-L1,and improve the kidney function.

关 键 词：肾病综合征 扶正益肾汤 糖皮质激素 SPD-1 sPD-L1 

分 类 号：R692[医药卫生—泌尿科学]