霉酚酸酯联合雷公藤多甙片治疗特发性膜性肾病的临床疗效分析

Clinical Effect of Mycophenolate Mofetil Combined Tripterygium Glycosides for the Treatment of Idiopathic Membranous Nephropathy

目的观察霉酚酸酯联合雷公藤多甙片治疗特发性膜性肾病(idiopathic membranous nephropathy,IMN)的临床疗效。方法选择作者医院收治的90例IMN患者,将其随机分为观察组以及对照组,每组45例,两组均给予激素治疗,同时对照组给予霉酚酸酯治疗,观察组在此基础上联合使用雷公藤多甙片进行治疗,比较两组患者的临床疗效、不良反应情况以及治疗前后的相关临床指标变化情况。结果对照组的治疗有效率为51.11%(23/45),观察组为88.89%(40/45),组间比较差异有统计学意义(χ2=8.491,P<0.05),经过治疗后两组患者的尿蛋白、纤维蛋白原、血浆白蛋白、肌酐、甘油三酯指标均较治疗前明显好转,且治疗后组间比较差异有统计学意义(P<0.05)。观察组中并发症的发生率为24.44%(11/45),对照组为17.78%(8/45),组间比较差异无统计学意义(χ2=1.048,P>0.05)。结论霉酚酸酯联合雷公藤多甙片治疗IMN能够有效缓解患者的病情,改善临床生化指标,安全性较好,值得推广应用。

Objective To analyze the clinical effect of using mycophenolate mofetil combined tripterygium glucoside for the treatment of idiopathic membranous nephropathy（IMN）.Methods 90 cases with IMN in author＇s hospital were randomly divided into observation group and control group with45 cases in each group,two groups all received hormonetherapy,and control group received mycophenolate mofetil for treatment,the observation group received combined tripterygium glucoside treatment,clinical efficacy,adverse reactions and changes of related clinical indexes before and after treatment in two groups were compared.Results The effective rate was 51.11%in the control group（23/45）,the observation group was 88.89%（40/45）,difference between groups had statistical significance（χ2=8.491,P〈0.05）,urinary protein,fibrinogen,plasma albumin,creatinine,three acyl glycerin indicator both markedly improved in the two groups after treatment,but difference between groups had statistical significance after treatment（P〈0.05）.The incidence of complications in the observation group was 24.44%（11/45）,in the control group was 17.78%（8/45）,there was no significant difference between groups（χ2=1.048,P〈0.05）.Conclusion Mycophenolate mofetil combined tripterygium glucoside piece using in the treatment for IMN can effectively alleviate the patients＇ condition,improve the clinical and biochemical indexes,has better security,is worthy of popularization and application.