雷公藤多苷片对原发性肾病综合征患者的疗效及炎症因子的影响

Effect of glycosides tablets on the patients with primary nephrotic syndrome and its influence on inflammatory factors

目的观察雷公藤多苷片对原发性肾病综合征患者的疗效及患者炎症状态的影响。方法选取2014年6月至2015年11月内江市市中区人民医院76例原发性肾病综合征患者,依据随机数表法分为观察组和对照组各38例。对照组采用常规治疗,观察组则在对照组治疗的基础上口服雷公藤多苷片1 mg/(kg·d)。比较两组间的临床疗效以及治疗前后两组患者间疾病相关实验室检测指标、安全性指标和炎症因子水平差异。结果观察组患者的病情完全缓解率和总有效率分别为44.74%及81.58%,略高于对照组的31.58%及68.42%,但差异均无统计学意义(P>0.05);治疗后,观察组患者24 h尿蛋白、血清尿素氮、肌酐清除率分别为(1.50±0.76)g/24 h、(4.12±1.21)mmol/L及(25.34±5.19)mL/min,明显低于对照组的(3.24±1.09)g/24 h、(5.03±1.26)mmol/L及(22.17±5.26)mL/min,肌酐水平为(219.23±57.61)mol/L,明显高于对照组的(208.49±67.43)mol/L,超敏C反应蛋白(hs-CRP)、白介素-18(IL-18)、白介素-1β(IL-1β)分别为(2.23±0.69)g/L、(11.35±5.08)pg/mL及(14.09±5.14)pg/mL,明显低于对照组的(2.92±0.87)g/L、(27.78±6.12)pg/mL及(19.65±7.28)pg/mL,以上各项指标组间差异均有统计学意义(P<0.05);治疗前后两组患者间血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、血钾(K)及血白细胞(ALB)水平比较差异均无统计学意义(P>0.05)。结论雷公藤多苷联合基础方案治疗PNS能够取得更好的临床疗效,能有效抑制自身免疫反应、保护肾功能。

Objective To observe the effect of glycosides tablets on the patients with primary nephrotic syn- drome （PNS） and its influence on inflammatory factors. Methods Seventy-six patients with PNS in our hospital from June 2014 to November 2015 were selected in the study and randomly divided into two groups： control group and ob- servation group, each with 38 cases. All the patients received basic treatment, and patients in the observation group were treated with 1 mg/（kg, d） glycosides tablets orally on the treatment of control group. Then the difference of effect between the two groups was compared, and the levels of disease related laboratory test indexes, safety indexes and in- flammatory factors of the two groups before and after treatment were also compared. Results The complete remis- sion rate and total effective rate of observation group were 44.74% and 81.58%, as compared with 31.58% and 68.42% in the control group （P〉0.05）. After treatment, the 24 h urinary protein, serum urea nitrogen, creatinine clearance rate of observation group were （1.50±0.76） g/24 h, （4.12± 1.21） mmol/L, （25.34±5.19） mL/min, significantly lower than （3.24±1.09） g/24 h, （5.03±1.26） mmol/L and （22.17±5.26） mL/min in the control group, while the serum creatinine level was （219.23±57.61） mol/L, which was significantly higher than （208.49±67.43） mol/L in the control group. The hyper- sensitive C-reactive protein （hs-CRP）, interleukin-18 （IL-18）, IL-1β levels were （2.23±0.69） g/L, （11.35±5.08） pg/mL, （14.09±5.14） pg/mL, significantly lower than （2.92±0.87） g/L, （27.78±6.12） pg/mL, （19.65±7.28） pg/mL in the control group （P〈0.05）. There was no significant difference in serum alanine aminotransferase （ALT）, aspertate aminotransfer- ase （AST）, potassium （K） and albumin （ALB） levels between the two groups before and after treatment （P〉0.05）. Conclusion Glycosides tablets combined with basic treatment can achieve better clinical efficacy in the treatment of PNS, which can effectively inhibit the immune response and protect renal fimction.