羟氯喹联合中小剂量激素治疗伴活动性增生病变IgA肾病的疗效观察  

The Effect of HydroxychloroquineCombined with Medium/Low Dose Corticosteroids in the Treatment of IgA Nephropathy with Active Hyperplastic Lesion

作　　者：薛痕[1] 郑光毅 常晓东[1] 何易 赵敏[1] 杨有芹 张露 XUE Hen;ZHENG Guang-yi;CHANG Xiao-dong;HE Yi;ZHAO Min;YANG You-qin;ZHANG Lu(Department of Nephrology,Ya′an People′s Hospital,Ya′an 625000,China)

机构地区：[1]四川省雅安市人民医院肾内科,四川雅安625000

出　　处：《实用医院临床杂志》2023年第3期54-57,共4页Practical Journal of Clinical Medicine

基　　金：雅安市科技计划项目(编号:21KJJH0015)。

摘　　要：目的探讨羟氯喹(HCQ)联合中小剂量糖皮质激素治疗伴活动性增生病变IgA肾病的疗效与安全性。方法纳入2010年1月至2022年6月于雅安市人民医院行肾活检诊断为伴活动性增生病变IgA肾病患者,HCQ联合中小剂量激素[强的松0.4~0.6 mg/(kg·d)]治疗组(A组)42例和足量激素[强的松0.8~1.0 mg/(kg·d)]治疗组(B组)46例,均随访6月。比较两种治疗方案的疗效及不良反应。结果第6个月时两组蛋白尿水平均较入组时明显下降(P<0.05),但两组24 h尿蛋白定量、完全缓解率及总有效率比较,差异无统计学意义(P>0.05);B组不良反应发生率高于A组(P<0.05)。结论羟氯喹联合中小剂量激素能有效降低伴活动性增生病变IgA肾病患者的蛋白尿,与足量激素疗效相当,但安全性更好。Objective To evaluate the efficacy and safety of hydroxychloroquine(HCQ)combined with medium/low dose corticosteroids in the treatment of IgA nephropathy(IgAN)with active hyperplasia.Methods This is a case-control study.Forty-two patients with IgAN who received HCQ combined with medium/low dose corticosteroids therapy were included.Forty-six matched historical controls who received full dose corticosteroids were selected by propensity score matching.The clinical data of 6 months were compared.Results At the 6 th months of treatment,the level of urinary protein in group A and group B decreased significantly compared with that at the time of entry(P<0.05),and there were no significant differences in 24 h urine protein quantification,complete remission rate and total effective rate between the two groups(P>0.05).The incidence of total adverse reactions in group B was higher than those in group A(P<0.05).Conclusions HCQ combined with medium/low dose corticosteroids can effectively reduce proteinuria in IgAN patients with active hyperplasia,and the effect is similar to that of full dose of corticosteroids,but the safety is better.

关 键 词：IGA肾病 羟氯喹 糖皮质激素 蛋白尿 

分 类 号：R692[医药卫生—泌尿科学]