缬沙坦联合尿激酶治疗IgA肾病的临床疗效观察

The Clinical Effect Observation of Valsartan Combined with Urokinase in Treatment of IgA Nephropathy

目的观察缬沙坦联合尿激酶治疗IgA肾病的临床疗效。方法选择2013年9月~2014年9月在潍坊市中医院住院治疗的40例IgA肾病患者,随机分为实验组和对照组,每组20例。实验组予缬沙坦＋尿激酶治疗,对照组予缬沙坦治疗。分别在用药前及用药后第1,2,4,6,8,10,12个月测24h尿蛋白定量、尿微量白蛋白（U-MA）、肾小球滤过率（GFR）、血肌酐（Scr）、血白蛋白（ALB）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、甘油三酯（TG）、胆固醇（TC）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）等血生化指标。结果用药12个月后两组患者24h尿蛋白定量均下降,差异有统计学意义（P〈0.05）,且实验组较对照组下降明显,差异有统计学意义（P〈0.05）。结论缬沙坦联合尿激酶较单独应用缬沙坦能更明显延缓IgA肾病的进展。

Objective To observe the clinical efficacy of valsartan combined with urokinase in treatment of IgA nephropathy. Methods From September 2013 to September 2014 in weifang traditional chinese medicine hospital,40 cases of IgA nephropathy patients,were randomly divided into experimental group and control group,20 cases in each group. The experimental group was treated valsartan combined with urokinase,the control group was treated with valsartan. The 24 h urine protein,urinary albumin U-MA,glomerular filtration rate（ GFR）,serum creatinine（ SCR）,serum albumin（ ALB）,alanine aminotransferase（ ALT）,aspartate aminotransferase（ AST）,triglyceride（ TG）,cholesterol（ TC）,high density lipoprotein（ HDL-C）,low density lipid protein（ LDL-C） and blood biochemical parameters were measured in the 1,2,4,6,8,10,12 months before and after treatment respectively. According to the blood uric acid level adjust the dose of allopurinol and febuxostat. Results After 12 months of treatment,two groups of patients with quantitative test of24 h urinary protein were decreased,the difference was statistically significant（ P〈0. 05）,the quantitative test of 24 h urinary protein in the experimental group was significantly lower than that of control group,the difference was statistically significant（ P〈0. 05）. Conclusion Valsartan combined with urokinase can significantly delay the progression of IgA nephropathy than valsartan alone.