糖皮质激素联合环磷酰胺治疗抗中性粒细胞胞浆抗体相关血管炎伴肾损害的疗效观察

Observation on the curative effect of glucocorticoid combined with cyclophosphamide in the treatment of antineutrophil cytoplasmic antibody associated vasculitis complicated with renal damage

目的:研究糖皮质激素联合环磷酰胺治疗抗中性粒细胞胞浆抗体相关血管炎(AAV)伴肾损害的临床效果。方法:2014年2月-2018年2月收治AAV伴肾损害患者80例,按照不同用药方式分为两组,各40例。对照组接受糖皮质激素单一治疗;观察组应用糖皮质激素联合环磷酰胺治疗,比较两组治疗效果。结果:观察组治疗后肾功能各项指标水平优于对照组,差异有统计学意义(P<0.05);两组慢性肾衰竭发生率比较,差异具有统计学意义(P<0.05);观察组治疗总有效率显著高于对照组,差异有统计学意义(P<0.05);观察组应用环磷酰胺导致的不良反应轻微,且例数较少。结论:采用激素与环磷酰胺联合治疗AAV伴肾损害患者,可有效改善肾脏损害情况,且药物不良反应较低,安全可靠。

Objective:To study the clinical effect of glucocorticoid combined with cyclophosphamide in the treatment of antineutrophil cytoplasmic antibody associated vasculitis(AAV)complicated with renal damage.Methods:80 cases of AAV complicated with renal damage were selected from February 2014 to February 2018.They were divided into the two groups with 40 cases in each group according to different medication methods.The control group was treated with glucocorticoid alone,and the observation group was treated with glucocorticoid and cyclophosphamide.The therapeutic effects of the two groups were compared.Results:The levels of renal function in the observation group were better than those in the control group after treatment,and the difference was statistically significant(P<0.05).There was significant difference in the incidence of chronic renal failure between the two groups(P<0.05).The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).In the observation group,the adverse reactions caused by cyclophosphamide were slight and few.Conclusion:The combination of hormone and cyclophosphamide can effectively improve the renal damage of AAV patients complicated with renal damage,and the adverse drug reactions are low,which is safe and reliable.