糖皮质激素联合复方α－酮酸治疗原发性肾病综合征的临床观察

摘要

Objective To investigate the therapeutic effect and safety of glucocorticoid combined with compoundα-keto acids therapy in primary nephrotic syndrome. Methods A prospective randomized controlled trial was carried out.Seventy-two cases of primary nephrotic syndrome were equally divided into treatment group and control group. Two groups of patients were both treated with glucocorticoids , and combined with compoundα-keto acid tablets in the treatment group. The level of BUN ,Scr,CRP,IL-6,PA、Alb,TG,TC,Ca in blood and eGFR、MTP were detected before treatment and the 2nd,4th,6th,8th month after treatment to evaluate the efficacy and safety respectively. Results After 8 months of treatment, the total effective rate in treatment group was significantly higher than that in the control group (P < 0.05); Compared with before treatment, the Alb level was significantly increased in both groups, the level of MTP,TC,TG,PA,CRP,IL-6 were significantly declined in both groups (P < 0.05),while no significant difference was found in the level of BUN,Scr,eGFR,serum calcium in both groups(P > 0.05); the level of MTP,TC,TG,CRP、IL-6 in the treatment group were significantly lower and the Alb level in the treatment group was significantly higher (P < 0.05)compared with the control group, while no significant difference was found in the level of PA、BUN、Scr、eGFR、serum calcium (P > 0.05) between two groups;All of patients with no serious adverse reactions occurred during the investigation. Conclusion The curative effect of glucocorticoid combined with compoundα-keto acids therapy in primary nephrotic syndrome is sure and without significant sideeffect.%目的：观察糖皮质激素联合复方α－酮酸治疗原发性肾病综合征的临床疗效和安全性。方法：采用前瞻性随机对照试验，选择72例原发性肾病综合征患者，随机分为治疗组和对照组。两组患者均使用糖皮质激素治疗，治疗组在此基础上加服复方α－酮酸片。随访治疗前、治疗2、4、6、8个月后，记录两组患者血BUN、Scr、CRP、IL-6、PA、Alb、TG、TC、Ca及eGFR、MTP水平，观察比较两组的临床疗效和安全性。结果：治疗8个月后，治疗组较对照组总有效率高（P ＜0．05）；与治疗前相比，治疗8个月后，两组 Alb 水平均明显上升，MTP、TC、TG、PA、CRP、IL-6水平均明显下降（P ＜0．05），而 BUN、Scr、eGFR、血 Ca 水平差异均无统计学意义（P ＞0．05）。治疗8个月后，治疗组较对照组 MTP、TC、TG、CRP、IL-6水平低，Alb 水平高（P ＜0．05），而PA、BUN、Scr、eGFR、血Ca水平差异无统计学意义（P ＞0．05）。所有患者在治疗过程中均未出现严重的不良反应。结论：糖皮质激素联合复方α-酮酸治疗原发性肾病综合征疗效确切，安全性尚可。