促红细胞生成素联合甲泼尼龙对急性间质性肾炎患者的疗效及IL-6 TNF-α水平的影响

Effect and Influence of Erythropoietin and Methylprednisolone on Acute Interstitial Nephritis patients and IL-6 TNF-alpha

目的:观察促红细胞生成素(EPO)联合甲泼尼龙对急性间质性肾炎(AIN)患者的疗效及治疗前后白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平的变化。方法:选择从2015年1月至2016年12月在医院接受治疗的AIN患者96例进行研究。根据随机原则将患者分成观察组以及对照组各48例,两组均停用可能导致AIN的药物,并纠正其酸中毒,同时维持其机体内水电解质的平衡。对照组予以甲泼尼龙,在治疗3d后改成泼尼松口服;观察组在对照组治疗的基础上另给予EPO治疗,两组患者均在治疗1个月后,评估临床疗效、不良反应。此外,通过ELISA检测技术检测患者血治疗前后清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平。结果:观察组的显效率是43.75%,总有效率是97.92%,均分别较对照组的16.67%和83.33%明显更高,差异均有统计学意义(均P<0.05)。观察组的少尿期时间、多尿期时间、血尿及蛋白尿均消失的时间及肾功能恢复至正常的时间均分别较对照组明显更少,差异均有统计学意义(均P<0.05)。治疗后两组的IL-6及TNF-α水平均较治疗前明显降低,且观察组较对照组更低,差异均有统计学意义(均P<0.05)。观察组治疗后的不良反应总发生率是10.42%,与对照组的12.50%相比,差异无统计学意义(P>0.05)。结论:应用EPO及甲泼尼龙对ANI患者实施治疗后的疗效较好,安全性较高,减少炎症因子释放,发挥抗炎作用,值得给予推广应用。

Objective：To study effect and its influence of interleukin-6 （IL-6）, tumor necrosis factor alpha （TNF-α） of erythropoietin and methylprednisolone in the treatment of patients with acute interstitial nephritis.Methods： 96 patients with AIN who were treated in our hospital from January 2015 to December 2016 were selected as study object.The patients were divided into observation group and control group with 48 cases in each group.The two groups were discontinued may lead to AIN drugs, and corrected the acidosis, while maintained the body of water electrolyte balance.The control group was given methylprednisolone, modified Chengponisong oral in the treatment of 3d, the observation group was another given EPO for treatment.Two groups were treated for 1 month then compared the comparison of efficacy, clinical indicators, adverse reactions, and the two groups before treatment and after treatment of IL-6 and TNF-α level.Results： The effective rate of the observation group was 43.75%, and the total effective rate was about 97.92%, respectively compared with the control group of 16.67% and 83.33% were significantly higher, the difference was statistically significant （P 〈 0.05）.In the observation group, the time of oliguria, the time of polyuria, the time of disappearance of hematuria and proteinuria, and the recovery of renal function to normal were significantly less than those in the control group, the difference was statistically significant （P 〈 0.05）.After treatment, the levels of IL-6 and TNF-α in two groups were significantly lower than those before treatment, and the observation group was lower than the control group, the difference was statistically significant （P 〈 0.05）.The total incidence of adverse reactions in the observation group was 10.42%, compared with the control group of 12.50%, the difference was not statistically significant （P 〉 0.05）.Conclusion： The application of EPO and methylprednisolone on the curative effect of treatment of AIN patients with better implementation of the high safety, reduce the release of inflammatory cytokines and anti-inflammatory action.It is worthy of application and popularization.