厄贝沙坦联合甲基泼尼松龙冲击治疗64例MsPGN的临床意义研究

Study on the Clinical Significance of Irbesartan Combined with Methylprednisolone in Treatment of 64 Cases of MsPGN

目的研究厄贝沙坦联合甲基泼尼松龙冲击治疗系膜增生性肾小球肾炎(Ms PGN)的临床治疗效果。方法选择2014年1月—2016年6月该院收治的64例系膜增生性肾小球肾炎患者的临床资料进行分析,根据随机数字法,把64例患者分成两组,取其中32例患者仅应用甲基泼尼松龙冲击治疗设为对照组,另外32例患者在对照组用药基础上增加厄贝沙坦治疗,经过1个月治疗后,对比两组患者血清、尿白蛋白、24 h尿蛋白定量等指标变化情况,以此分析临床治疗效果和不良反应。结果观察组总缓解率100%,对照组总缓解率87.5%,观察组总缓解率明显比对照组高,两组对比差异有统计学意义(P<0.05);观察组用药后发生1例感染,1例水钠潴留、1例消化道出血;对照组用药后出现1例感染、2例水钠潴留、1例消化道出血。两组治疗后,感染、水钠潴留及消化道出血等不良反应差异无统计学意义(P>0.05),而且两组患者不良反应轻,临床用药未受影响。结论厄贝沙坦联合甲基泼尼松龙冲击治疗能通过不同途径对机体免疫炎症活动起到抑制作用,对患者肾小球病变起到逆转作用,对尿蛋白的排泄起到控制作用。厄贝沙坦联合甲基泼尼松龙冲击治疗系膜增生性肾小球肾炎(MsPGN)疗效理想,而且不良反应较轻,患者临床各项症状和体征改善效果理想,总缓解率较高,值得借鉴推广。

Objective To study the effect of irbesartan combined with methylprednisolone in treatment of mesangial proliferative glomerulonephritis（Ms PGN） clinical curative effect. Methods Select from January 2014 to June 2016 in our hospital 64 cases of mesangial proliferative glomerulonephritis were divided into two groups, only the application of methylprednisolone pulse therapy as control group, the control group was observed in the treatment group increase irbesartan treatment on the basis of one month after treatment, compared two groups of therapeutic effects and adverse reactions. Results Observation group, the overall response rate was100% in the control group, the total response rate of 87.5% in the observation group, the overall response rate was significantly higherthan the control group, between two groups was significant difference（P〈0.05）; the occurrence of one case of infection after drug administration were 1 case sodium retention, one case of gastrointestinal bleeding; 1 case of infection in the control group after treatment, two cases of water and sodium retention, one case of gastrointestinal bleeding. After treatment, infection, sodium retention and gastrointestinal bleeding and other adverse reactions was no significant difference（P〉0.05）, and two groups of patients with mild adverse reactions, unaffected clinical practice. Conclusion Irbesartan combined with methylprednisolone treatment can inhibit the effect by different ways on the immune inflammation plays to the reversal effect on patients with glomerular lesions, to control the effect on urinary protein excretion from.irbesartan combined with methylprednisolone in treatment of mesangial proliferative glomerulonephritis（MsPGN） ideal curative effect, and less adverse reactions, clinical symptoms and signs of the patients improved effect is ideal, the total remission rate is higher, is worthy of promotion.