环孢霉素A与环磷酰胺联合激素对重症IgA肾病的疗效比较  

To Compare the Efficacy of Cyclosporine A and Cyclophosphamide Combined with Hormone in Severe IgA Nephropathy

作　　者：田燕 曾春兰 TIAN Yan;ZENG Chunlan(Chongqing Liangjiang New District First People’s Hospital,Chongqing 401121,China;不详)

机构地区：[1]重庆两江新区第一人民医院,重庆401121

出　　处：《中外医学研究》2021年第18期143-145,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨环孢霉素A(CsA)、环磷酰胺(CTX)结合激素治疗重症IgA肾病(IgAN)的效果。方法:2018年1月-2019年1月60例重症IgAN患者随机数字表法分为对照组、观察组,各30例。对照组给予CTX+激素治疗,观察组给予CsA+激素治疗。比较两组疗效、24 h尿蛋白定量(24 h UP)、血肌酐(Scr)、肾小球滤过率(GFR)、血清白介素-18(IL-18)、转化生长因子-β1(TGF-β1)、不良反应。结果:观察组总有效率(86.67%)高于对照组(63.33%),差异有统计学意义(P<0.05);治疗后两组24 h UP降低,观察组低于对照组(P<0.05);两组Scr、GFR水平差异无统计学意义(P>0.05);治疗后两组血清IL-18、TGF-β1水平下降,观察组低于对照组(P<0.05);观察组不良反应(20.00%)与对照组(23.33%)比较差异无统计学意义(P>0.05)。结论:CsA联合激素治疗重症IgAN的效果优于CTX联合激素,能够提高疗效,降低尿蛋白水平,改善血清IL-18、TGF-β1水平。Objective:To investigate the effect of Cyclosporine A (CsA) and Cyclophosphamide (CTX) combined with hormone therapy on severe IgA nephropathy (IgAN).Method:A random number table of 60 severe IgAN patients in our hospital from January 2018 to January 2019 was selected and divided into control group and observation group,30 cases each.The control group was given CTX+hormone therapy,and the observation group was given CsA+hormone therapy.Efficacy,24 h urinary protein quantification (24 h UP),serum creatinine (Scr),glomerular filtration rate (GFR),serum interleukin-18 (IL-18),transforming growth factor-1 (TGF-1),and adverse reactions were compared between the two groups.Result:The total effective rate in the observation group (86.67%) was higher than 63.33% in the control group (P<0.05).After treatment,24 h UP was decreased in both groups,while that in the observation group was lower than that in the control group (P<0.05).There was no significant difference in Scr and GFR between the two groups (P>0.05).After treatment,serum levels of IL-18 and TGF-1 in both groups decreased,and those in the observation group were lower than those in the control group (P<0.05).There was no significant difference in adverse reactions between the observation group (20.00%) and the control group (23.33%) (P>0.05).Conclusion:The efficacy of CsA combined with hormone therapy for severe IgAN is superior to that of CTX combined with hormone therapy,which can improve the efficacy,reduce the urinary protein level,and improve the serum IL-18 and TGF-1 levels.

关 键 词：重症IgA肾病 环孢霉素A 环磷酰胺 激素 

分 类 号：R692.31[医药卫生—泌尿科学]