环磷酰胺联合糖皮质激素治疗特发性膜性肾病的临床效果分析

Clinical effect of cyclophosphamide and glucocorticoid in the treatment of idiopathic membranous nephropathy

目的探究环磷酰胺与糖皮质激素联合用药方案治疗特发性膜性肾病的临床效果。方法 102例特发性膜性肾病患者为研究对象,依据随机数字表法分为对照组和观察组,每组51例。对照组应用糖皮质激素治疗,观察组采用环磷酰胺与糖皮质激素联合用药方案治疗。对比两组患者的临床治疗效果、不良反应发生率以及治疗前后的血清肌酐(Scr)、血清白蛋白、24 h尿蛋白定量水平。结果观察组患者的临床治疗总有效率98.04%高于对照组的78.43%,差异具有统计学意义(P<0.05)。观察组患者的不良反应发生率9.80%低于对照组的35.29%,差异具有统计学意义(P<0.05)。治疗前,两组患者的Scr、血清白蛋白、24 h尿蛋白定量水平对比,差异无统计学意义(P>0.05);治疗后,观察组患者的Scr水平为(71.68±10.13)μmol/L、24 h尿蛋白定量水平为(2.14±1.01)g/24 h低于对照组的(87.34±3.12)μmol/L、(3.87±0.15)g/24 h,血清白蛋白水平为(37.11±1.24)g/L高于对照组的(32.26±2.21)g/L,差异具有统计学意义(P<0.05)。结论环磷酰胺与糖皮质激素联合用药方案治疗特发性膜性肾病的临床效果显著,可有效减少患者不良反应发生,改善肾功能,促进患者康复,值得临床推广应用。

Objective To investigate the clinical effect of cyclophosphamide and glucocorticoid in the treatment of idiopathic membranous nephropathy. Methods A total of 102 patients with idiopathic membranous nephropathy as study subjects were divided into control group and observation group according to random numerical table, with 51 cases in each group. The control group was treated with glucocorticoid, and the observation group was treated with cyclophosphamide and glucocorticoid. The clinical effect, incidence of adverse reactions, and serum creatinine(Scr), serum albumin and 24 h urine protein quantification before and after treatment were compared between the two groups. Results The total effective rate of clinical treatment 98.04% of the observation group was higher than 78.43% of the control group, and the difference was statistically significant(P<0.05). The incidence of adverse reactions 9.80% of the observation group was lower than 35.29% of the control group, and the difference was statistically significant(P<0.05). Before treatment, there was no statistically significant difference in Scr, serum albumin, and 24 h urine protein quantification between the two groups(P>0.05). After treatment, the Scr(71.68±10.13) μmol/L and 24 h urine protein quantification(2.14±1.01) g/24 h of the observation group were lower than(87.34±3.12) μmol/L and(3.87±0.15) g/24 h of the control group, and serum albumin(37.11±1.24) g/L was higher than(32.26±2.21) g/L of the control group. The difference was statistically significant(P<0.05). Conclusion The clinical effect of cyclophosphamide combined with glucocorticoid is significant in the treatment of idiopathic membranous nephropathy, which can effectively reduce the occurrence of adverse reactions, improve the renal function and promote the rehabilitation of patients, which is worthy of clinical promotion and application.