1，25-二羟维生素D3联合缬沙坦减少IgA肾病尿蛋白的疗效观察

摘要

Objective To observe the efficacy of 1 ,25-dihydroxyvitamin D3 plus valsartan treatment for IgA nephropathy .Methods Sixty patients with IgA nephropathy were randomly divided into valsartan group ,valsar-tan combined with 1 ,25-dihydroxyvitamin D3 (VD3 )(calcitriol) groups(valsartan+ VD3 ) .And combination group was divided into group 1 and group 2 .After treating for 6 months ,the changes of urinary protein ,renal function , serum Potassium and serum potassium were remeasured.Results After the treatment ,level of urine protein in all groups were significantly decreased( P<0 .05)and that in combination group 2 was significantly lower than that in other groups( P <0 .05) .All patients had no side effects or hypercalcemia .Conclusion Valsartan plus 1 ,25-di-hydroxyvitamin D3 can effectively reduce the level of urinary protein in patients with IgA nephropathy .It was more effective than single drug treatment .Valsartan plus 1 ,25-dihydroxyvitamin D3 may be a more preferential therapeutic schedule for the initial treatment of IgA nephropathy.%目的：观察1，25-二羟维生素D3（VD3）联合缬沙坦减少IgA肾病尿蛋白的疗效。方法将60例肾活检明确诊断为IgA肾病的患者采用随机数字表法分为ARB组和ARB＋ VD3组，ARB＋ VD组根据所应用的1，25-二羟维生素D3的剂量分为联合治疗组1和组2，观察6个月，治疗过程中监测血压，检测治疗前后尿蛋白、肾功能、血钙、血钾水平。结果治疗后3组尿蛋白均较基线下降，差异有统计学意义（ P ＜0．05），且3组之间尿蛋白的下降程度两两比较，各组差异有统计学意义（ P ＜0．05），联合治疗组2下降最为显著，无明显不良反应。结论1，25-二羟维生素D3联合缬沙坦对减少Ig A肾病尿蛋白有较好的疗效，联合较大剂量1，25-二羟维生素D3效果更为显著，为Ig A肾病的初始治疗提供更优先的方案。