吗替麦考酚酯联合雷公藤多苷治疗难治性肾病综合征患者疗效及对肾功能的影响

摘要

Objective To observe the effect of mycophenolate mofetil and tripterygium glycosides on the renal func-tion of refractory nephrotic syndrome.Methods From June 2010 to August 2013, 82 cases of refractory nephrotic syndrome patients were randomly divided into control group (40 cases) and observation group (42 cases).Control group were treated with mycophenolate mofetil therapy, patients in the observation group was treated with mycophenolate mofetil combined with tripterygium glycosides.Clinical therapeutic effect and renal function (24 h urinary protein, blood urea nitrogen, serum albu-min, serum creatinine) changes were compared between the 2 groups.Results The total efficiency of the observation group was 73.8%(31/42), which was higher than that of the control group of 47.5% (19/40) (χ2 =5.960, P <0.05);24 h urinary protein, blood urea nitrogen, serum albumin, serum creatinine were improved in both of the 2 groups than before treat-ment ( t =9.440, t =17.750, t =5.710, t =2.803, t =11.473, t =13.823, t =9.685, t =4.671, P <0.05), 24 h uri-nary protein, Alb, SCr improved more obviously in observation group ( t =3.427, t =3.099, t =2.362, P <0.05);the re-currence rate was 0 in the observation group, which was lower than that in control group of 15.8%(3/19) (χ2 =5.207, P <0.05);no significant difference of adverse reactions were found between the 2 groups (21.4%vs.27.5%,χ2 =0.410, P >0.05).Conclusion Refractory nephrotic syndrome could be treated by mycophenolate mofetil combined with tripterygium gly-cosides, the clinical effects are significant, adverse reactions are slightly.%目的：观察吗替麦考酚酯联合雷公藤多苷治疗难治性肾病综合征患者的效果及对肾功能的影响。方法选择2010年6月—2013年8月难治性肾病综合征患者82例，随机数字表法分为对照组（40例）和观察组（42例）。对照组患者应用吗替麦考酚酯治疗，观察组患者则应用吗替麦考酚酯联合雷公藤多苷治疗。比较2组患者的临床治疗效果及肾功能（24 h尿蛋白定量、尿素氮、血清白蛋白、血肌酐）变化情况。结果观察组总有效率73趑．8％（31／42）高于对照组的47．5％（19／40）（χ2＝5．960， P ＜0．05）；2组患者的24 h尿蛋白定量、尿素氮、血清白蛋白、血肌酐均较治疗前改善（ t 对＝9．440、17．750、5．710、2．803， t 观＝11．473、13．823、9．685、4．671， P ＜0．05），并且观察组患者24 h尿蛋白定量、Alb、SCr改善较对照组更加明显（ t ＝3．427、3．099、2．362， P ＜0．05）；观察组复发率为0，低于对照组的15．8％（3／19）（χ2＝5．207， P ＜0．05）；2组不良反应发生率比较差异无统计学意义（21．4％ vs．27．5％，χ2＝0．410， P ＞0．05）。结论难治性肾病综合征患者应用吗替麦考酚酯联合雷公藤多苷治疗，临床效果显著，不良反应轻微。