氯沙坦钾联合前列地尔治疗慢性肾小球肾炎临床疗效及对血清IL-1、TNF-α和sFlt-1的影响

Clinical Effect of Losartan Potassium Combined with Aalprostadil in Treatment of Patients with Chronic Glomerulonephritis and Its Effects on Serum IL-1,TNF-α and s Flt-1

目的探讨氯沙坦钾联合前列地尔治疗慢性肾小球肾炎临床疗效及对血清白介素-1(IL-1)、肿瘤坏死因子α(TNF-α)和可溶性血管内皮生长因子受体(s Flt-1)的影响。方法选取2015年1月—2017年5月收治的慢性肾小球肾炎147例,按治疗方法分为对照组64例和研究组83例。对照组在常规治疗基础上予以氯沙坦钾治疗,研究组在对照组基础上加用前列地尔治疗。2组均治疗3个月。观察2组临床疗效,治疗后血清IL-1、TNF-α、s Flt-1水平及肾功能各指标变化情况,同时记录不良反应发生情况。结果研究组临床总有效率高于对照组(P<0.05)。2组治疗后血清IL-1、TNF-α和s Flt-1水平均明显低于治疗前,且研究组低于对照组(P<0.05,P<0.01)。2组治疗后肾功能各指标均较治疗前明显改善,且研究组改善程度优于对照组(P<0.05,P<0.01)。研究组不良反应发生率低于对照组(P<0.05)。结论氯沙坦钾联合前列地尔治疗慢性肾小球肾炎临床疗效显著,可明显改善其肾功能,降低血清中IL-1、TNF-α和s Flt-1水平,且安全可靠,为提高慢性肾小球肾炎患者的诊治水平提供了参考依据。

Objective To investigate clinical effect of Losartan Potassium combined with Alprostadil in treatment of patients with chronic glomerulonephritis and its effects on expressions of serum interleukin-1 （ IL-1 ） , tumor necrosis factor-α （TNF-α） and soluble vascular endothelial growth factor receptor-1 （ sFlt-1 ）. Methods A total of 147 patients with chronic glomerulonephritis admitted during January 2015 and May 2017 were divided into control group （ u = 64 ） and study group （ u = 83 ） according to different treatments. Control group was treated with Losartan Potassium on the basis of conventional therapy, and study group was treated with Alprostadil on the basis of treatment for control group. All patients were treated for 3 months. Clinical effect, serum IL-1, TNF-α and sFlt-1 levels and changes of renal function indexes after treatment were observed, and incidence rates of adverse reactions were recorded simuhaneously in two groups. Results The total effective rate in study group was significantly higher than that in control group （ P 〈 0.05 ）. After treatment, levels of serum IL-1, TNF-α and sFlt-1 were significantly lower than those before treatment in two groups, and the levels in study group were significantly lower than those in control group （ P 〈 0.05, P 〈 0.01 ）. After treatment, indexes of renal function were significantly improved after treatment in two groups, and the improvement degrees in the study group were superior than those in control group （P 〈 0.05, P 〈 0.01 ）. Incidence rate of adverse reactions in study group was significantly lower than that in control group （ P 〈 0.05 ）. Conclusion Losartan Potassium combined with Alprostadil in treatment of patients with chronic glomerulonephritis may achieve good clinical effect, significantly improve renal function and decrease serum IL-1, TNF-α and sFlt-1 levels with safety, and therefore it may provide a reference for improving diagnosis and treatment.