MMF联合雷公藤多苷在治疗IgA肾病患者中的临床对照研究  

The clinical controlled study of MMF combined with Triperygium wilfordii multiglucoside in the treatment of patients with IgA nephropathy

作　　者：符育群 陈菊[1] FU Yu-qun;CHEN Ju(Department of Nephrology and Rheumatology Haikou Hospital Affiliated to Xiangya Medical College,Central South University Haikou 570208,China)

机构地区：[1]中南大学湘雅医学院附属海口医院肾病风湿科,海口570208

出　　处：《现代免疫学》2021年第3期199-203,共5页Current Immunology

摘　　要：为探讨吗替麦考酚酯(mycophenolate mofetil,MMF)联合雷公藤多苷在治疗IgA肾病患者中的疗效与安全性,以中南大学湘雅医学院附属海口医院2017年3月至2019年4月收治的124例IgA肾病患者为研究对象,随机分为对照组(62例)和观察组(62例);对照组给予雷公藤多苷治疗,观察组在此基础上给予MMF治疗;对比两组尿蛋白、血清蛋白、血脂指标、体液免疫指标、肾功能指标及疗效和不良反应。结果显示,治疗后3个月,观察组尿蛋白(2.12±1.23)g/L、血清蛋白(34.08±4.72)g/L,与对照组[(4.46±2.38)g/L、(22.54±4.61)g/L]相比差异显著(均P<0.05)。治疗后6个月,观察组血清总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)及C3、IgA水平[(4.03±1.02)mmol/L、(1.12±0.78)mmol/L、(5.72±0.53)g/L、(31.06±3.28)g/L]与对照组[(5.04±1.16)mmol/L、(1.48±0.91)mmol/L、(17.48±1.68)g/L、(52.37±5.51)g/L)]相比显著降低(均P<0.05)。治疗后6个月,观察组血尿素氮(blood urea nitrogen,BUN)、尿酸、血肌酐水平[(7.21±1.65)mmol/L、(397.62±12.17)mmol/L、(81.07±11.23)μmol/L]与对照组[(8.16±1.71)mmol/L、(409.11±12.79)mmol/L、(96.83±10.92)μmol/L)]相比显著降低(均P<0.05)。观察组治疗有效率为96.77%,对照组有效率为85.48%,两组差异显著(P<0.05)。治疗6个月后,观察组不良反应发生率为8.06%,对照组为6.45%,两组差异无统计学意义(χ^(2)=0.120,P=0.729)。由此,MMF联合雷公藤多苷在治疗IgA肾病患者时可改善其尿蛋白、血清蛋白、血脂、体液免疫和肾功能指标,疗效较好且不良反应发生率低。To investigate the efficacy and safety of mycophenolate mofetil(MMF) combined with Triperygium wilfordii multiglucoside in the treatment of patients with IgA nephropathy, 124 patients with IgA nephropathy were enrolled from March 2017 to April 2019 in Haikou Hospital Affiliated to Xiangya Medical College, Central South University as research objects and were randomly divided into the control group(62 cases) and the observation group(62 cases);The control group was treated with Triperygium wilfordii multiglucoside and the observation group was given MMF in addition;The proteinuria, serum protein, lipidemia index, humoral immune index, renal function index, curative effect and adverse reactions were compared between the two groups. After 3 months of treatment, the differences in proteinuria [(2.12±1.23) g/L] and serum protein [(34.08±4.72) g/L] in the observation group were significantly higher compared with those in the control group [(4.46±2.38) g/L,(22.54±4.61) g/L, both P<0.05]. Six months after treatment, the levels of serum total cholesterol(TC), triglyceride(TG), C3 and IgA [(4.03±1.02) mmol/L,(1.12±0.78) mmol/L,(5.72±0.53) g/L,(31.06±3.28) g/L] were significantly lower than those in the control group [(5.04±1.16) mmol/L,(1.48±0.91) mmol/L,(17.48±1.68) g/L,(52.37±5.51) g/L](all P<0.05). Six months after treatment, the blood urea nitrogen(BUN), uric acid, blood creatinine levels [(7.21±1.65) mmol/L,(397.62±12.17) mmol/L,(81.07±11.23) μmol/L] in the observation group were significantly different from those of the control group [(8.16±1.71) mmol/L,(409.11±12.79) mmol/L,(96.83±10.92) μmol/L](all P<0.05). The efficacy rate of the observation group was 96.77% as opposed to 85.48% in the control group(P<0.05). After 6 months of treatment, there was no difference in the incidence of adverse reactions between the two groups(8.06% vs 6.45%, χ2=0.120, P=0.729). In conclusion, MMF combined with Triperygium wilfordii multiglucoside shows a better curative effect and lower adverse reactions as reflect

关 键 词：IGA肾病 吗替麦考酚酯 雷公藤多苷 疗效 安全性 

分 类 号：R692.6[医药卫生—泌尿科学]