羟苯磺酸钙在肾移植后蛋白尿治疗中的应用

Application of calcium dobesilate in renal transplant recipients with proteinuria

目的探讨羟苯磺酸钙辅助治疗肾移植后蛋白尿的有效性和安全性。方法 60例肾移植后蛋白尿患者随机分为两组,每组30例,均常规应用免疫抑制剂治疗,观察组加用羟苯磺酸钙0.5 g,po,tid。分别于治疗前和治疗1、3、6个月后检测24 h尿蛋白定量(Urp)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、血β2微球蛋白(β2-MG)、肌酐清除率(Ccr)、肝及肾功能,并记录不良反应的发生情况。结果治疗前两组各项指标均相近(P>0.05)。观察组临床总有效率、完全缓解率分别为83%、27%,均高于对照组(33%、7%,P<0.05),两组疗效差异显著(P<0.05)。对照组治疗后各项指标均无显著变化(P>0.05),观察组治疗1个月后,Urp、尿NAG酶、血β2-MG均开始下降,Ccr开始升高(P<0.05),且各观察时点Urp、尿NAG酶、血β2-MG低于对照组,Ccr高于对照组,差异均有显著意义(P<0.05)。治疗期间两组均未见严重不良反应。结论羟苯磺酸钙辅助治疗肾移植后蛋白尿安全有效。

AIM To investigate the efficacy and safety of calcium dobesilate in adjutant treatment of renal transplant recipients with proteinuria. METHODS Sixty renal transplant recipients with proteinuria were randomly divided into observation group and control group （30 patients in each）. All patients were given conventional immunosuppressant, and the patients in the observation group were added with calcium dobesilate （0.5 g, po, tid）. The changes of 24-hour urine protein （Urp）, urinary N-acetyl-beta-D-amino glycosidase enzymes （NAG）, blood beta 2-micro globulin （β2-MG）, creatinine clearance rate （Ccr）, liver and renal allograft function were observed before and after 1, 3, 6 months of the treatment respectively. The occurrence of adverse reactions was also recorded during the treatment. RESULTS The levels of each index were similar between two groups before the treatment （P 〉 0.05）. The clinical total effective rate and complete response rate of the observation group were 83% and 27%, higher than those in the control group （33% and 7%, P 〈 0.05）.There was statistically significant difference in clinical efficacy between two groups t.r 〈 u.uJ j. ~ didn＇t change obviously in the control group （P 〉 0.05）. The levels of Urp, NAG, [3^-MG began to decrease one month after the treatment in the observation group （P 〈 0.05）, and lower than those in the control group at each observed point （P 〈 0.05）. The level of Ccr was increased one month after the treatment in the observation group （P 〈 0.05）, and higher than that in the control group at each observed point （P 〈 0.05）. No severe adverse reactions occurred during treatment. CONCLUSION Calcium dobesilate is effective and safe in adjutant treatment of renal transplant recipients with proteinuria.