资源描述:
《环孢素a与环磷酰胺联合激素治疗特发性膜性肾病的疗效比较》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、环孢素A与环磷酰胺联合激素治疗特发性膜性肾病的疗效比较[摘要]目的对比观察环孢素A(CsA)与环磷酰胺(CTX)联合激素治疗特发性膜性肾病的疗效与安全性。方法选取门诊长期随访的经肾活检确诊的特发性膜性肾病患者40例,随机分为CsA组与CTX组各20例,分别给予CsA联合糖皮质激素,CTX联合糖皮质激素治疗,疗程12个月。观察各组治疗前后尿蛋白定量、血浆白蛋白、血脂、肝、肾功能、血白细胞总数变化及其他不良反应,及两组患者治疗前后的缓解率。结果治疗3、6个月末CsA组的尿蛋白定量[关键词]环孢素A;环磷酰胺;激素;特发性膜性肾病分类号]R6
2、92.3[文献标识码]A[文章编号]2095-0616(2014)16-16-04ComparisononthetherapeuticeffectofcyclosporinAandcyclophosphamideinthetreatmentofidiopathicmembranousnephropathyCHENZhongfenglZHANGJianwei2XIANannanlHEBingl1.DepartmentofNephrology,ZhengzhouCentralHospitalAffiliatedtoZhengzhouUniv
3、ersity,Zhengzhou450007,China;2.HenanTraditionalChineseMedicineCollege,Zhengzhou450000,China[Abstract]ObjectiveToobservecomparativelytheefficacyandsafetyofcyclosporineA(CsA)andcyclophosphamide(CTX)combinedhormoneinthetreatmentofidiopathicmembranousnephropathy(IMN).Methods
4、40outpatientswhowerefollowed-叩foralongtimewithidiopathicmembranousnephropathy(IMN)confirmedbybiopsywererandomLydividedintotwogroups:CsAgroupandCTXgroup.TreatmentsweregivenrespectivelyCsAcombinedwithglucocorticoids,CTXcombinedwithglucocorticoidsfor12months.Toobservechange
5、sin24hurinaryprotein,serumalbumin,serumcholesterol,liverfunction,kidneyfunction,bloodleukocytes,otheradversereactions,andremissionratesbeforeandaftertreatmentineachgroup.ResultsThe24hurineproteinandserumcholesterolofCsAgroupwerelowersignificantlythanCTXgroupaftertreatmen
6、tfor3monthsand6months(P0.05).TheremissionrateofCsAgroupwashighersignificantlythanCTXgroupaftertreatmentfor3monthsand6months(x2=5.11,P0.05).ConclusionComparedwithCTX,CsAcombinedwithhormonehasequivalentefficacyintreatmentfortheIMN,butCsAhasfasteronset,bettercurativeeffect,
7、lessadversereactionsthanCTX.[Keywords]CyclosporineA;Cyclophosphamide;Hormone;Idiopathicmembranousnephropathy特发性膜性肾病(idiopathicmembranousnephropathy,IMN)免疫介导的肾小球疾病,是肾病综合征中最常见的病理类型之一,其临床表现有轻重不同,预后差别较大。IMN的治疗一直存在很大争议,至今没有公认的疗效满意的治疗方案,有研究认为单纯激素治疗效果不佳,临床上以激素联合CTX较为常用,但因其副作用较多
8、而严重,患者难以耐受[1],因此,寻找疗效较好,毒性较低的IMN治疗方案一直是临床噬待解决的问题[2-3]。自1985年环孢素A(cyclosporineA,CsA)首次用于治疗肾病综合征以来,取得了较好的