环磷酰胺治疗肾病综合征对患者ApoA1、ApoB、Lp(a)的影响  

Effect of cyclophosphamide treatment of nephrotic syndrome on ApoA1,ApoB,and Lp(a)in patients

作　　者：张俊涛 何旭 蒋俊杰[3] ZHANG Juntao;HE Xu;JIANG Junjie(Pharmacy Department of Jinzhai County Traditional Chinese Medicine Hospital Anhui,Jinzhai,Anhui,China,237300;Nephrology Department of Jinzhai County Traditional Chinese Medicine Hospital Anhui,Jinzhai,Anhui,China,237300;Pharmacy Department of Lu'an People's Hospital Anhui,Lu'an,Anhui,China,237005)

机构地区：[1]金寨县中医医院药学部,安徽金寨237300 [2]金寨县中医医院肾内科,安徽金寨237300 [3]六安市人民医院药学部,安徽六安237005

出　　处：《分子诊断与治疗杂志》2024年第12期2244-2247,2251,共5页Journal of Molecular Diagnostics and Therapy

基　　金：安徽省卫生健康科研项目(AHWJ2022a033)。

摘　　要：目的探讨肾病综合征患者应用环磷酰胺联合泼尼松治疗对肾功能及血清载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、脂蛋白(a)[Lp(a)]水平的影响。方法前瞻性选取金寨县中医医院2021年1月至2024年1月收治的96例肾病综合征患者,按照随机数字表法将选取的患者分为接受醋酸泼尼松片单独治疗的对照组(n=48)和联合注射用环磷酰胺治疗的研究组(n=48)。两组患者的具体用药剂量均根据患者不良反应及耐受情况进行调整,且均接受为期12个月的治疗。对两组疗效(治疗12个月后)、炎症因子[白细胞介素(IL)⁃6、IL⁃8、肿瘤坏死因子⁃α(TNF⁃α)]、肾功能指标(尿素氮、血清肌酐、胱抑素C)及ApoA1、ApoB、Lp(a)水平(治疗前和12个月后)进行比较。结果较对照组(72.92%),研究组治疗12个月后的总缓解率(89.58%)更高,差异具有统计学意义(P<0.05)。较治疗前,两组治疗12个月后的血清IL⁃6、IL⁃8、TNF⁃α、尿素氮、肌酐、胱抑素C、ApoA1、ApoB、Lp(a)水平下降,研究组较对照组更低,差异具有统计学意义(均P<0.05)。结论肾病综合征患者应用环磷酰胺联合泼尼松治疗可降低血清ApoA1、ApoB、Lp(a)水平,改善血脂代谢紊乱状态,同时可减轻机体炎症,改善肾功能,疗效显著。Objective To investigate the effects of treatment with cyclophosphamide combined with prednisone on renal function and serum apolipoprotein A1(ApoA1),apolipoprotein B(ApoB),and lipoprotein(a)[Lp(a)]levels in patients with nephrotic syndrome.Methods 96 cases of patients with nephrotic syndrome admitted to Jinzhai County Traditional Chinese Medicine Hospital from January 2021 to January 2024 were prospectively selected and divided into a control group(n=48)receiving prednisone acetate tablets alone,and a study group(n=48)receiving injectable cyclophosphamide in addition to prednisone acetate.The divison was done according to a randomized numerical table method.The dosage of the drug in both groups was adjusted based on the patientsadverse reactions and tolerance.Both groups received treatment for 12 months.The efficacy after 12 months of treatment,levels of inflammatory factors[interleukin(IL)⁃6,IL⁃8,tumor necrosis factoralpha(TNF⁃α)],renal function indexes(urea nitrogen,serum creatinine,cystatin C),and ApoA1,ApoB,and Lp(a)levels(before and after 12 months of treatment)were compared between the two groups.Results Compared to the control group(72.92%),the study group had a higher overall remission rate after 12 months of treatment(89.58%),and this difference was statistically significant(P<0.05).Additionally,after 12 months of treatment,both groups showed a decrease in serum levels of IL⁃6,IL⁃8,TNF⁃α,urea nitrogen,creatinine,cystatin C,ApoA1,ApoB,and Lp(a)compared to pretreatment levels.The levels were lower in the study group than in the control group,and these differences were statistically significant(P<0.05).Conclusion The use of cyclophosphamide in combination with prednisone for treating patients with nephrotic syndrome can lower serum levels of ApoA1,ApoB,and Lp(a),improve lipid metabolism disorders,and reduce inflammation and enhance renal function.This treatment has shown siginificant efficacy.

关 键 词：肾病综合征 环磷酰胺 泼尼松 载脂蛋白A1 载脂蛋白B 脂蛋白A 

分 类 号：R692[医药卫生—泌尿科学]