肝豆灵联合DMPS治疗对Wilson病肾损伤的影响

Effect of Gandouling Combined with DMPS Therapy for Renal Injury in Patients of Wilson’s disease

目的:观察肝豆灵联合DMPS(二巯丙磺钠注射液)治疗Wilson病患者尿白蛋白肌酐比(UACR)、转铁蛋白(UTRF)、免疫球蛋白G(UIgG)、β2-微球蛋白(Uβ2-MG)及α1-微球蛋白(Uα1-MG)等早期肾损伤指标的影响及临床价值。方法:随机将59例Wilson病患者分为2组,对照组DMPS治疗,实验组肝豆灵+DMPS治疗,共干预4个疗程,分别观察治疗前后肾损伤标记物、24h尿CU等变化。结果:2组治疗后肾损伤指标均降低(P<0.05);治疗后实验组肾损伤指标UACR、UIgG、Uβ2-MG、Uα1-MG水平显著低于对照组(P<0.05),治疗后UTRF指标2组间差异不显著(P>0.05);治疗后2组患者24 h尿CU排泄水平较治疗前显著增多(P<0.05),实验组Wilson病患者24尿Cu水平较对照组显著增加(P<0.05)。结论:肝豆灵联合DMPS治疗Wilson病疗效肯定,肝豆灵能增加尿CU排出且降低肾损伤指标提示其具有肾脏保护、修复作用。

Objective:To observe the effect and clinical value of gandouling combined with DMPS therapy of Wilson patients with early renal injury,such as urinary albumin creatinine ratio(UACR),transferrin(UTRF),ImmunoglobulinG(UIgG),β2-microglobulin(Uβ2-MG)andα1-microglobulin(Uα1-MG).Method:A total of 59 patients were randomly divided into two groups,the control group treated with DMPS and the experimental group treated with gandouling+DMPS.To observe respectively changes of renal injury markers and 24h urine CU before and after treatment with 4 courses.Results:The indexes of renal injury after treatment were reduced in both groups(P<0.05).After treatment,the renal injury indexes UACR,UIgG,Uβ2-MG and Uα1-MG in the experimental group were significantly lower than those in the control group(P<0.05),and there was no significant difference in the UTRF index between the two groups(P>0.05).After treatment,the urinary CU level of the two groups was significantly increased at 24h compared with that before treatment(P<0.05),and that of the patients in the experimental group was significantly increased compared with that of the control group(P<0.05).Conclusion:Gandouling combined with DMPS therapy of Wilson’s disease has a positive effect.Gandouling can increase urinary CU excretion and reduce renal injury indicators,suggesting that it has renal protection and repair effects.