血管紧张素受体拮抗剂治疗IgA肾病疗效观察

Efficiency of angiotensin Ⅱ receptor blocker on IgA nephropathy

目的 观察血管紧张素受体拮抗剂（immunoglobulin A nephropathy,ARB）在不同病理类型IgAN患者中的疗效及安全性.方法 根据Lee氏分级,将30例患者分为Lee氏2级组（3例、）Lee氏3级组（18例）和Lee氏4级组（9例）,都服用相同剂量的ARB（替米沙坦80mg/d）,并进行了长达1年的随访,观察收缩压、舒张压、血肌酐、尿素氮、尿酸、eGFR、血糖、胆固醇、甘油三酯、血钾、高倍镜下红细胞及24h尿蛋白等变化情况.结果 替米沙坦治疗1年后,Lee氏2级组患者的尿蛋白缓解率为100％,Lee氏3级组为43.8％,而Lee氏4级组仅为11.1％.与入组时基线值相比,各组各时间点血肌酐、尿素氮、尿酸、eGFR、血糖、胆固醇、甘油三酯及血钾均没有明显变化.结论 IgAN患者ARB的使用是相对安全、有效的,但其病理类型直接影响ARB药物的治疗效果.

Objectives To observe the efficacy and safety of ARB in IgAN patients with different pathological types.Methods According to Lee＇s classification,the patients were divided into three groups：Lee＇s 2 group,Lee＇s 3 group and Lee＇s 4 group.All patients take the same dose ARB （telmisartan 80 mg / d）,and we follow-up observed the patients＇systolic blood pressure,diastolic blood pressure,serum creatinine,blood urea nitrogen,uric acid,eGFR,blood sugar,cholesterol,triglycerides,blood potassium,high magnification RBC and 24h urine protein changes for at least one year.Results After treated with Telmisartan for one year,the urine protein response rate in the 3 groups were 100％,43.8％ and 11.1％ respectively.And compared to baseline values,the serum creatinine,blood urea nitrogen,uric acid,eGFR,blood sugar,cholesterol,triglycerides and blood potassium did not change significantly.Conclusions ARB is relatively safe and effective in IgAN patients but the pathological type a direct impact on the therapeutic effect of ARB drugs.