回顾性分析ACEI／ARB联用激素对微小病变型肾病综合征的影响

Review analysis on the effect of angiotensin-converting enzyme inhibitor and or angiotensin receptor antagonist(ACEI/ARB) combined with prednisone on minimal change nephropathy

目的研究血管紧张素转换酶抑制剂/血管紧张素受体拮抗剂(ACEI/ARB)联合激素治疗微小病型肾病综合征(MCD)的疗效。方法回顾性分析1998年11月至2006年10月肾活检确诊为MCD的患者,分为激素单联用ACEI或ARB组、激素联用ACEI及ARB组,及单用激素组作为对照。结果符合入组94例,激素单联用ACEI或ARB组(36例),复发率52.78%;激素联用ACEI及ARB组(30例),复发率56.67%;单用激素组(28例),复发率46.43%,其复发率及尿蛋白转阴时间均无统计学差异(P>0.05)。结论激素联用ACEI及或ARB不能降低MCD患者的复发率及缩短尿蛋白转阴时间。

Objective To study the effect of angiotensin - converting enzyme inhibitor and or angiotensin receptor antagonist （ACEI/ARB） combined with prednisone on minimal change nephropathy （MCD）. Methods Ninety -four patients with minimal change nephropathy were divided into prednisone combined with ACEI or ARB group, prednisone combined with ACEI and ARB group, and single -use prednisone group （control） during November 1998 - October 2006. Results Prednisone combined with ACEI or ARB group were 36 cases, relapse rate was 52.78%. Prednisone combined with ACEI and ARB group were 30 cases, relapse rate was 56.67%. Single -use prednisone group were 28 cases, relapse rate was 46.43%. The relapse rate and remission time of proteinuria was no significant difference between no combined group and prednisone combined with ACEI and or ARB group （ P 〉 0. 05 ）. Conclusion ACEI and or ARB combined with prednisone in patients with MCD did not reduce the relapse rate and increase the likelihood and duration of remission.