环孢素A联合泼尼松治疗进展性IgA肾病的临床效果观察(1)
【摘要】 目的：探讨环孢素A联合激素疗法治疗进展性IgA肾病的临床效果。方法：纳入笔者所在医院2013年1月-2015年11月进展性IgA肾病的患者60例，随机平均分为两组，每组30例，其中激素联合环孢素A组给予环孢素A联合泼尼松治疗；激素组仅采用泼尼松治疗，观察时间共28周，比较两组近期疗效、毒性及不良反应发生率。结果：激素组和激素联合环孢素A组治疗总有效率分别为86.67%和96.67%，两组比较差异有统计学意义(P<0.05)；两组白细胞减少、中性粒细胞减少、血小板减少发生率比较，差异无统计学意义(P>0.05)；激素联合环孢素A组患者感染及肝功能損害发生率高于激素组，差异有统计学意义(P<0.05)；激素组的恶心、乏力、厌食、头晕等不良反应发生率高于激素联合环孢素A组，差异均有统计学意义(P<0.05)。结论：环孢素A联合激素替代疗法治疗进展性IgA肾病有效，全身性不良反应少，但肝功能不全及有感染风险患者慎用。
【关键词】 环孢素A； 激素； 血肌酐升高； IgA肾病； 安全性
doi：10.14033/j.cnki.cfmr.2017.9.003 文献标识码 A 文章编号 1674-6805(2017)09-0006-02
【Abstract】 Objective：To investigate the clinical efficacy of Cyclosporine A combined with hormone therapy in the treatment of progressive IgA nephropathy.Method：Sixty patients with progressive IgA nephropathy were enrolled in our hospital from January 2013 to November 2015.The patients were randomly divided into two groups，30 cases in each group.The hormone combined with Cyclosporin A group was given Cyclosporin A and Prednisone for treatment.The hormone group was given Prednisone for treatment.They were observed for 28 weeks.The effective rate and hormone levels of the two groups were compared before and after treatment.The recent curative effect，toxic and adverse reaction rates were compared between the two groups.Result：The effective rates of the hormone and the hormone combined with Cyclosporin A group were 86.67% and 96.67% respectively，the differences were statistically significant(P<0.05).There was no significant difference between the two groups in the incidence rates of leukopenia，neutropenia and thrombocytopenia(P>0.05).The incidence rates of infection，liver function damage of the hormone combined with Cyclosporine A group was significantly higher than those of the hormone group，the differences were statistically significant(P<0.05).The incidence rates of nausea，fatigue，anorexia，dizziness of the hormone group were significantly higher than those of the hormone combined with Cyclosporine A group，the differences were statistically significant(P<0.05).Conclusion： Cyclosporin A combined with hormone replacement therapy for the treatment of progressive IgA nephropathy is effective，it has less systemic adverse reactions，but liver failure and risk of infection in patients shall be noted.
【Key words】 Cyclosporin A； Hormone； Serum creatinine elevation； IgA nephropathy； Safety
First-author’s address：Traditional Chinese Medicine Hospital of Nandan County，Nandan 547200，China
IgA肾病(IgA nephropathy，IgAN)是我国最常见的原发性肾小球疾病，多数学者认为有持续性蛋白尿者预后差，控制蛋白尿可延缓肾功能衰竭的进展[1]。对病初大量蛋白尿、高血压和/或肾功能异常等高度提示慢性进展性IgAN者仍主张积极治疗，免疫抑制剂使用上，环孢素A为临床上使用较多的一线药物。但是长期疗效欠佳，近年来采用联合药物治疗的方法在临床不断开展，环孢素A联合激素疗法在临床上取得了较为满意的疗效，发挥着药物优势互补的作用[2]。本文通过对激素和激素联合环孢素A疗法治疗进展性IgA肾病的临床治疗效果及副作用观察，以期为该病的治疗提供一定的理论依据。, http://www.100md.com(索斌诚)
【关键词】 环孢素A； 激素； 血肌酐升高； IgA肾病； 安全性
doi：10.14033/j.cnki.cfmr.2017.9.003 文献标识码 A 文章编号 1674-6805(2017)09-0006-02
【Abstract】 Objective：To investigate the clinical efficacy of Cyclosporine A combined with hormone therapy in the treatment of progressive IgA nephropathy.Method：Sixty patients with progressive IgA nephropathy were enrolled in our hospital from January 2013 to November 2015.The patients were randomly divided into two groups，30 cases in each group.The hormone combined with Cyclosporin A group was given Cyclosporin A and Prednisone for treatment.The hormone group was given Prednisone for treatment.They were observed for 28 weeks.The effective rate and hormone levels of the two groups were compared before and after treatment.The recent curative effect，toxic and adverse reaction rates were compared between the two groups.Result：The effective rates of the hormone and the hormone combined with Cyclosporin A group were 86.67% and 96.67% respectively，the differences were statistically significant(P<0.05).There was no significant difference between the two groups in the incidence rates of leukopenia，neutropenia and thrombocytopenia(P>0.05).The incidence rates of infection，liver function damage of the hormone combined with Cyclosporine A group was significantly higher than those of the hormone group，the differences were statistically significant(P<0.05).The incidence rates of nausea，fatigue，anorexia，dizziness of the hormone group were significantly higher than those of the hormone combined with Cyclosporine A group，the differences were statistically significant(P<0.05).Conclusion： Cyclosporin A combined with hormone replacement therapy for the treatment of progressive IgA nephropathy is effective，it has less systemic adverse reactions，but liver failure and risk of infection in patients shall be noted.
【Key words】 Cyclosporin A； Hormone； Serum creatinine elevation； IgA nephropathy； Safety
First-author’s address：Traditional Chinese Medicine Hospital of Nandan County，Nandan 547200，China
IgA肾病(IgA nephropathy，IgAN)是我国最常见的原发性肾小球疾病，多数学者认为有持续性蛋白尿者预后差，控制蛋白尿可延缓肾功能衰竭的进展[1]。对病初大量蛋白尿、高血压和/或肾功能异常等高度提示慢性进展性IgAN者仍主张积极治疗，免疫抑制剂使用上，环孢素A为临床上使用较多的一线药物。但是长期疗效欠佳，近年来采用联合药物治疗的方法在临床不断开展，环孢素A联合激素疗法在临床上取得了较为满意的疗效，发挥着药物优势互补的作用[2]。本文通过对激素和激素联合环孢素A疗法治疗进展性IgA肾病的临床治疗效果及副作用观察，以期为该病的治疗提供一定的理论依据。, http://www.100md.com(索斌诚)