注射用红花黄色素联合环孢素A和泼尼松治疗老年膜性肾病的临床研究

Clinical study on Safflower Yellow for injection combined with cyclosporine and prednisone in treatment of senile membranous nephropathy

目的探讨注射用红花黄色素联合环孢素A和泼尼松治疗老年膜性肾病的临床疗效。方法选取2015年9月—2016年9月在邯郸市中心医院进行治疗的老年膜性肾病患者98例,依据用药的差别分成对照组(49例)和治疗组(49例)。对照组口服醋酸泼尼松片,0.5 mg/(kg·d),2次/d,同时口服环孢素软胶囊,2 mg/(kg·d),2次/d。治疗组在对照组的基础上静脉滴注注射用红花黄色素,100 mg加入生理盐水250 m L,1次/d。两组患者均治疗4周。评价两组患者临床疗效,同时比较治疗前后两组患者相关指标和血清指标。结果治疗后,对照组总有效率为81.63%,显著低于治疗组的95.92%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者24 h尿蛋白(24 h UTP)、血肌酐(Scr)、尿素氮(BUN)、总胆固醇(TC)和三酰甘油(TG)水平均明显降低,而血清白蛋白(ALB)明显增高,同组比较差异具有统计学意义(P<0.05);且治疗组上述指标改善程度显著优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者血清基质金属蛋白酶抑制因子-1(TIMP-1)水平降低,而基质金属蛋白酶-9(MMP-9)水平增高,同组比较差异具有统计学意义(P<0.05);且治疗组比对照组改善更明显,两组比较差异具有统计学意义(P<0.05)。结论注射用红花黄色素联合环孢素A和泼尼松治疗老年膜性肾病效果显著,可明显改善患者肾功能,具有一定的临床推广应用价值。

Objective To study the clinical efficacy of Safflower Yellow for injection combined with cyclosporine and prednisone in treatment of elderly senile membranous nephropathy.Methods Patients （98 cases） with membranous nephropathy in Handan Central Hospital from September 2015 to September 2016 were divided into control （49 cases） and treatment （49 cases） groups based on different treatments. Patients in the control group werepoadministered with Prednisone Acetate Tablets, 0.5 mg/（kg＆#183;d）, twice daily, at the same timethey were poadministered with Ciclosporin Soft Capsules, 2 mg/（kg＆#183;d）, twice daily. Patients in the treatment group were iv administered with Safflower Yellow for injection on the basis of the control group, 100 mg added into normal saline 250 mL, once daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the relative indexes and serum indexes in two groups before and after treatment were compared.Results After treatment, the clinical efficacy in the control group was 81.63%, which was significantly lower than 95.92% in the treatment group, and there were differences between two groups （P 〈 0.05）. After treatment, the 24 h UTP, Scr, BUN, TC and TG levels in two groups were significantly decreased, but the serum ALB level was significantly increased, and the difference was statistically significant in the same group （P 〈 0.05）. And the improvement of these indicators in the treatment group was significantly better than those in the control group, with significant difference between two groups （P 〈 0.05）. After treatment, the TIMP-1 level in two groups was significantly decreased, but the MMP-9 level was significantly increased, and the difference was statistically significant in the same group （P 〈 0.05）. And the levels in the treatment group were significantly better than those in the control group, with significant difference between two groups （P 〈 0.05）.Conclusion Safflower Yellow for injection combined with cyclosporine and prednisone has significant clinical efficacy in treatment of senile membranous nephropathy, can obviously improve the renal function, which has a certain clinical application value.