环磷酰胺联合糖皮质激素治疗特发性膜性肾病的效果及安全性  

Clinical efficacy and safety of cyclophosphamide combined with glucocorticoid in treatment of idiopathic membranous nephropathy

作　　者：刘应中[1] 赵金丽[2] Liu Yingzhong;Zhao Jinli(Department of Nephrology,General Hospital of Taiyuan Iron and Steel Group,the Sixth Hospital of Shanxi Medical University,Taiyuan 030003,China;Department of Pediatrics,General Hospital of Taiyuan Iron and Steel Group,the Sixth Hospital of Shanxi Medical University,Taiyuan 030003,China)

机构地区：[1]太原钢铁(集团)有限公司总医院山西医科大学第六医院肾内科,太原030003 [2]太原钢铁(集团)有限公司总医院山西医科大学第六医院儿科,太原030003

出　　处：《中国实用医刊》2021年第24期100-102,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨环磷酰胺联合糖皮质激素治疗特发性膜性肾病的效果及安全性。方法抽取2016年1月至2018年12月太原钢铁(集团)有限公司总医院收治的特发性膜性肾病患者56例。根据治疗药物不同,将其分为环孢素A组和环磷酰胺联合糖皮质激素组,每组28例。比较环孢素A组和环磷酰胺联合糖皮质激素组患者的临床疗效,治疗前和治疗6个月后的尿蛋白定量、血清白蛋白,以及治疗期间不良反应发生情况。结果治疗6个月后,环磷酰胺联合糖皮质激素组患者临床总有效率(96.43%)高于环孢素A组的71.43%(P<0.05)。治疗6个月后,环孢素A组和环磷酰胺联合糖皮质激素组患者尿蛋白定量较治疗前降低,血清白蛋白较治疗前升高,P<0.05;治疗6个月后,环磷酰胺联合糖皮质激素组患者尿蛋白定量低于环孢素A组,血清白蛋白高于环孢素A组(P<0.05)。环孢素A组和环磷酰胺联合糖皮质激素组患者的不良反应发生率比较(25.00%比21.43%),P>0.05。结论环磷酰胺联合糖皮质激素治疗特发性膜性肾病具有较好的临床疗效和较高的安全性,可降低尿蛋白水平,提高血清白蛋白含量,缓解患者临床症状,改善患者的肾脏功能,有效促进患者康复。Objective To explore the clinical efficacy and safety of cyclophosphamide combined with glucocorticoid in the treatment of idiopathic membranous nephropathy.Methods Fifty-six patients with idiopathic membranous nephropathy admitted to General Hospital of Taiyuan Iron and Steel Group from January 2016 to December 2018 were included retrospectively.According to different drugs,they were divided into cyclosporine A group and cyclophosphamide combined with glucocorticoid group,with 28 cases in each group.The clinical efficacy,urinary protein quantification,serum albumin and adverse reactions during treatment were compared between cyclosporine A group and cyclophosphamide combined with glucocorticoid group.Results After 6 months of treatment,the total clinical effective rate of cyclophosphamide combined with glucocorticoid group(96.43%)was significantly higher than 71.43% of cyclosporine A group(P<0.05).After 6 months of treatment,urinary protein in cyclosporine A group and cyclophosphamide combined with glucocorticoid group decreased and serum albumin increased compared with that before treatment(P<0.05).After 6 months of treatment,the urinary protein and serum albumin in cyclophosphamide combined with glucocorticoid group were lower than those in cyclosporine A group and higher than those in cyclosporine A group(P<0.05).There was no significant difference in the incidence of adverse reactions between cyclosporine A group and cyclophosphamide combined with glucocorticoid group(25.00%vs.21.43%),P>0.05.Conclusions Cyclophosphamide combined with glucocorticoid has good clinical efficacy and high safety in the treatment of idiopathic membranous nephropathy,which can significantly reduce urine protein content,increase serum albumin level,relieve patients’clinical symptoms,improve patients’renal function,and effectively promote patients’rehabilitation.It is worthy of popularization and application in the treatment of idiopathic membranous nephropathy.

关 键 词：环磷酰胺 糖皮质激素 特发性膜性肾病 

分 类 号：R692[医药卫生—泌尿科学]