强的松联合来氟米特或雷公藤多苷对紫癜性肾炎患者尿蛋白及C-反应蛋白的影响

Effect of prednisone combined with leflunomide or tripterygium glycosides on urinary protein and serum C-reactive protein in Henoch-Schonlein purpura nephritis patients

目的研究强的松联合来氟米特或雷公藤多苷对紫癜性肾炎（HSPN）患者尿蛋白及血清C-反应蛋白（CRP）的影响，对比上述两种治疗方式的疗效。方法对40例新发血尿合并蛋白尿HSPN患者进行回顾性分析，其中21例使用强的松联合雷公藤多苷治疗（治疗组I）；19例使用强的松联合来氟米特治疗（治疗组Ⅱ）。分别选取同期长治医学院附属和济医院健康体检中心接诊的健康体检者12例（对照组I）和皮肤科门诊就诊的单纯型过敏性紫癜（HSP）患者15例（对照组Ⅱ）作为两个对照组。上述四组在性别、年龄上均匹配。上述四组在治疗前分别留24h尿液行尿蛋白定量测定；同时进行抽血、分离血清，用免疫比浊法检测血清c-反应蛋白（CRP）。两组治疗组在治疗1周后再次按上述方法化验24h尿蛋白量及检测血清CRP。结果健康体检者和HSP患者24h尿蛋白定量分别为（90±21）、（103±26）mg，血清CRP分别为（9±5）、（20±13）μg/L。治疗组I和治疗组Ⅱ在治疗前24h尿蛋白定量分别为（1030±136）、（1098±186）mg（P〉0．05），血清CRP分别为（38±20）、（40±20）μg/L（P〉0．05）；在治疗后其24h尿蛋白定量分别为（646±85）、（445±65）mg（P〈0．05），血清CRP分别为（28±16）、（18±11）μg／L（P〈0．05）。结论强的松联合来氟米特或雷公藤多苷治疗血尿合并蛋白尿HSPN患者，均能降低尿蛋白水平，降低血清CRP水平；强的松联合来氟米特治疗HSPN患者比强的松联合雷公藤多苷疗效更好。

Objective To investigate the effect of prednisone combined with leflunomide or tripterygium glycosides on urinary protein and serum C-reactive protein（CRP） in Henoch-Schonlein pur-pura nephritis （HSPN） patients. Methods Fourty cases of hematuria and proteinuria in patients with HSPN were retrospectively analyzed. Twenty-one cases of the 40 patients were stimulated by prednisone combined with tripterygium glycosides （treatment group I ） , and the others were stimulated by predni- sone combined with leflunomide（treatment group Ⅱ ）. At the same time, 12 cases health examination people were used as control group I and 15 henoch-Schonlein purpura patients were considered as con- trol group 11. Before treatment, two control groups and treatment groups before treatment were blood for the detection of serum CRP concentration through immunoturbidimetric assay; And 24 hours urine pro- teins of them were quantitatively determinated. After 1 week treatment, the two treatment groups were a- gain tested by above ways. Results Twenty-four hours urine proteins of control group I and I1 were （90±21）, （103 ±26）mg respectively, and the concentration of serum CRP were （9 ± 5 ）, （20±13） μg/L respectively. Twenty-four hours urine proteins of treatment group I and Ⅱ before treatment were （1030±136）, （1098±186）mg （P 〉 0.05）, and the concentration of serum CRP in them were （38 ±20 ）, （ 40±20 ） Ixg/L respectively （P 〉 0. 05 ）. Twenty-four hours urine proteins of treatment group I and Ⅱ after treatment for 1 week were （646± 85 ）, （445±65 ） mg （ P 〈 0. 05 ）, and the concentration of serum CRP in them were（28±16）, （18 ±11 ）μg/L respectively （P 〈 0.05 ）. Condusions Prednisone combined with leflunomide or tripterygium glycosides could reduce urinary protein loss and serum CRP concentration in patients with HSPN. The treatment effect of the former is better than the one of the latter.