血管紧张素转化酶抑制剂或血管紧张素Ⅱ受体阻滞剂联合糖皮质激素治疗IgA肾病疗效观察  

Effect of angiotensin converting enzyme inhibitors or angiotensinⅡreceptor blockers combined with glucocorticoid in the treatment of IgA nephropathy

作　　者：孙晓莉[1] 辛卫丽 郭永兵 SUN Xiaoli;XIN Weili;GUO Yongbing(Department of Nephrology and Rheumatology,Anyang District Hospital,Anyang 455000,Henan Province,China)

机构地区：[1]安阳地区医院肾病风湿科,河南安阳455000

出　　处：《新乡医学院学报》2024年第6期581-584,共4页Journal of Xinxiang Medical University

摘　　要：目的探讨血管紧张素转化酶抑制剂(ACEI)或血管紧张素Ⅱ受体阻滞剂(ARB)联合糖皮质激素治疗IgA肾病患者的临床疗效。方法选择2019年10月至2022年10月安阳地区医院收治的125例IgA肾病患者为研究对象。将患者随机分为对照组(n=62)和观察组(n=63),对照组患者给予ACEI或ARB类药物治疗,观察组患者在对照组的基础上加用丙酸氟替卡松吸入气雾剂治疗,2组患者均连续治疗3个月。比较2组患者治疗后的效果。分别于治疗前后检测2组患者24 h尿蛋白定量、肾功能指标血肌酐(Scr)、肾小球滤过率(GFR)和血常规指标白细胞计数(WBC)、血红蛋白(HGB)水平、血小板计数(PLT)。记录2组患者治疗期间不良反应发生情况。结果对照组和观察组患者治疗总有效率分别为54.84%(34/62)、84.13%(53/63),观察组患者治疗总有效率显著高于对照组(χ^(2)=12.669,P<0.05)。治疗前2组患者24 h尿蛋白定量、Scr、GFR比较差异无统计学意义(P>0.05)。对照组患者治疗前后24 h尿蛋白定量比较差异无统计学意义(P>0.05),观察组患者治疗后24 h尿蛋白定量显著低于治疗前(P<0.05);2组患者治疗后Scr显著低于治疗前,GFR显著高于治疗前(P<0.05)。治疗后,观察组患者24 h尿蛋白定量显著低于对照组(P<0.05);2组患者Scr、GFR比较差异无统计学意义(P>0.05)。2组患者治疗前后WBC、HGB、PLT水平比较差异均无统计学意义(P>0.05)。2组患者治疗过程中均未出现糖耐量异常、类固醇性糖尿病、血压升高等不良反应。结论丙酸氟替卡松吸入气雾剂联合ACEI或ARB类药物治疗IgA肾病患者,可降低24 h尿蛋白定量,有助于肾功能的改善,疗效显著,且不会对患者造成血液系统损伤,安全性较高。Objective To investigate the clinical efficacy of angiotensin converting enzyme inhibitors(ACEI)or angiotensinⅡreceptor blockers(ARB)combined with glucocorticoid in treating IgA nephropathy patients.Methods A total of 125 IgA nephropathy patients admitted to Anyang District Hospital from October 2019 to October 2022 were selected as the research subjects.The patients were randomly divided into the control group(n=62)and the observation group(n=63).Patients in the control group were given ACEI or ARB treatment,while patients in the observation group were given ACEI or ARB combined with fluticasone propionate inhalation aerosol.All patients were treated continuously for 3 months.The treatment effect was compared between the two groups.The 24-hour urinary protein quantitation,serum creatinine(Scr),glomerular filtration rate(GFR),white blood cell(WBC)count,hemoglobin(HGB)level,and platelet(PLT)count of patients in the two groups were measured before and after treatment.The occurrence of adverse reactions during treatment in the two groups was recorded.Results The overall effective rates of patients in the control group and the observation group were 54.84%(34/62)and 84.13%(53/63),respectively;the overall effective rate of patients in the observation group was significantly higher than that in the control group(χ^(2)=12.669,P<0.05).Before treatment,there was no significant difference in 24-hour urinary protein quantitation,Scr and GFR between the two groups(P>0.05).There was no significant difference in 24-hour urinary protein quantitation of patients before and after treatment in the control group(P>0.05),and the 24-hour urinary protein quantitation of patients after treatment in the observation group was significantly lower than that before treatment(P<0.05).After treatment,Scr in the two groups was significantly lower than that before treatment,and GFR was significantly higher than that before treatment(P<0.05).After treatment,24-hour urinary protein quantitation in the observation group was significantly lower

关 键 词：血管紧张素转化酶抑制剂 血管紧张素Ⅱ受体阻滞剂 糖皮质激素 IGA肾病 

分 类 号：R586[医药卫生—内分泌]