环磷酰胺联合糖皮质激素治疗膜性肾病效果分析  

Effect analysis of cyclophosphamide combined with glucocorticoid on membranous nephropathy

作　　者：陈想娜 刘变玲[1] 沈蓓莉 范阳贞 CHEN Xiang-na;LIU Bian-ling;SHEN Bei-li;FAN Yang-zhen(Nephrology Department,Zhengzhou People's Hospital,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州人民医院肾内科,河南郑州450000

出　　处：《青岛医药卫生》2022年第1期63-66,共4页Qingdao Medical Journal

摘　　要：目的探讨应用环磷酰胺治疗膜性肾病(Membranous nephropathy, MN)的临床效果及对患者血清磷脂酶A2受体(PLA2R)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)水平的影响。方法选择本院2018年6月至2020年1月收治的MN患者82例,随机分为对照组和研究组各41例,对照组采用糖皮质激素—醋酸泼尼松治疗,研究组则在对照组基础上辅以环磷酰胺治疗。评价两组临床疗效,同时观察患者24h尿蛋白定量、血清白蛋白与血清PLA2R、NGAL等生化指标变化情况。结果治疗后,研究组总有效率高于对照组,差异有统计学意义(P<0.05);研究组24h尿蛋白定量低于对照组,血清白蛋白水平高于对照组,差异有统计学意义(P<0.05);研究组24h血清PLA2R、NGAL水平低于对照组,差异有统计学意义(P<0.05)。结论环磷酰胺联合糖皮质激素在MN患者治疗中,能够改善患者临床症状,降低患者血清PLA2R、NGAL水平。Objective To explore the clinical effect of cyclophosphamide in treating membranous nephropathy(MN) and its influence on serum phospholipase A2 receptor(PLA2 R) and neutrophil gelatinase-associated lipocalin(NGAL). Methods A total of 82 patients with MN admitted to our hospital from June 2018 to January 2020 were randomly divided into control group and study group, with 41 cases in each group.The control group was treated with glucocorticoid-prednisone acetate, while the study group was treated with cyclophosphamide on the basis of the control group. The clinical efficacy of the two groups was evaluated, and the changes of biochemical indexes such as urinary protein quantification, serum albumin, serum PLA2 R and NGAL were observed. Results After treatment, the total effective rate of the study group was higher than that of the control group(P<0.05).The 24-hour urine protein level in the study group was lower than that in the control group, and the serum albumin level was higher than that in the control group, with statistical significance(P<0.05). The levels of serum PLA2 R and NGAL in the study group at 24 h were lower than those in the control group, and the difference was statistically significant(P<0.05). Conclusion Cyclophosphamide combined with glucocorticoid can improve the clinical symptoms and reduce the levels of PLA2 R and NGAL in patients with MN.

关 键 词：膜性肾病 环磷酰胺 糖皮质激素 肾功能 PLA2R NGAL 

分 类 号：R587[医药卫生—内分泌]