环磷酰胺联合糖皮质激素治疗原发性抗中性粒细胞胞浆抗体相关性小血管炎伴肾损害的疗效观察

Observation on Efficacy of Cyclophosphamide Combined with Glucocorticoid in Treatment of Primary ANCA Associated Vasculitis with Renal Damage

目的:探讨环磷酰胺联合糖皮质激素治疗原发性抗中性粒细胞胞浆抗体相关性小血管炎伴肾损害的疗效。方法:选取2014年8月—2015年7月仙桃市第一人民医院收治的原发性抗中性粒细胞胞浆抗体相关性小血管炎伴肾损害患者80例作为研究对象。以随机数字表法分为观察组和对照组,每组各40例。对照组患者给予糖皮质激素治疗,观察组患者在对照组基础上给予环磷酰胺治疗。比较2组患者治疗前后肾功能指标变化情况。结果:治疗前,2组患者血肌酐、尿红细胞计数、尿白蛋白水平的差异无统计学意义(P>0.05);治疗后,观察组患者血肌酐、尿红细胞计数、尿白蛋白水平均明显优于对照组,差异均有统计学意义(P<0.05);2组患者慢性肾衰竭发生率的差异无统计学意义(P>0.05)。结论:环磷酰胺联合糖皮质激素治疗原发性抗中性粒细胞胞浆抗体相关性小血管炎伴肾损害的效果显著,可有效改善患者肾功能。

OBJECTIVE ：To probe into the efficacy of cyclophosphamide combined with glucocorticoid in treatment of primary ANCA associated vasculitis with renal damage. METHODS： 80 patients with renal damage in primary ANCA associated vaseulitis admitted into the First People＇s Hospital of Xiantao from Aug. 2014 to Jul. 2015 were selected to be divided into observation group and control group via the random number table, with 40 cases in each. The control group were treated with glucocorticoid therapy, while the observation group additionally received cyclophosphamide based on the control group. Changes of renal function indexes of two groups were compared. RESULTS： Before treatment, there was no statistical significance between two groups in serum creatinine, hematuria and proteinuria level （P 〉 0. 05 ）. After treatment, the serum creatinine, hematuria and proteinuria level of observation group were significantly better than those of control group, with statistically significant difference （P 〈 0. 05 ）. And the incidence of chronic renal failure of two groups were compared, the difference was not statistically significant （ P 〉 0. 05 ）. CONCLUSIONS ： The effects of cyclophosphamide combined with glucocorticoid in treatment of primary ANCA associated vasculitis with renal damage is remarkable, which can effectively improve patients＇ renal function.