不同剂量雷公藤多苷联合缬沙坦治疗慢性肾小球肾炎患者的临床疗效

Effects of Different Doses of Tripterygium Glycosides combined with Valsartan on Matrix Metalloproteinases-9,Renal Function and Urine Protein in the Patients with Chronic Glomerulonephritis

目的:研究不同剂量雷公藤多苷联合缬沙坦治疗慢性肾小球肾炎(CGN)患者的临床疗效,观察其对患者基质金属蛋白酶9(MMP-9)、肾功能以及尿蛋白的影响。方法:回顾性分析本院2016年2月~2019年10月收治且经临床明确诊断的102例CGN患者的临床资料。根据治疗药物不同剂量分为A组和B组,比较两组的临床疗效,治疗前后血清肌酐(SCr)、β2微球蛋白(β2-MG)及尿素氮(BUN)、24h尿蛋白定量、生活质量及不良反应发生情况,并空腹抽取患者治疗前后3ml静脉血,采用酶联免疫吸附法检测两组患者MMP-9水平,并进行对比。结果:治疗后,A组总有效率(91.84%)高于B组(73.58%),具有统计学差异(P<0.05);治疗后,两组肾功能指标SCr、BUN、β2-MG、24h尿蛋白定量水平下降、血清MMP-9水平均较治疗前上升,生活质量均较治疗前上升;且A组SCr、BUN、β2-MG、24h尿蛋白定量水平低于B组,MMP-9水平与生活质量高于B组(P<0.05);两组不良反应发生率比较无统计学差异(P>0.05)。结论:雷公藤多苷联合缬沙坦治疗CGN患者效果较好,且通过调整雷公藤多苷的起始剂量可有效改善患者肾功能、提高临床疗效与生活质量,其内在机制可能与更有效的增加MMP-9水平有关,且安全性更高。

Objective:To study the clinical efficacy of different doses of tripterygium glycosides combined with valsartan in the treatment of patients with chronic glomerulonephritis(CGN),and observe its effects on matrix metalloproteinases-9(MMP-9),renal function and urine protein.Methods:The clinical data of 102 CGN patients who were admitted in our hospital from February 2016 to October 2019 and clinically diagnosed were retrospectively analyzed.According to different drug doses,they were divided into group A and group B.The clinical effects,serum creatinine(SCr),β2-micro globulin(β2-MG),blood urea nitrogen(BUN),and 24-hour urine protein quantification before and after treatment,quality of life and adverse reactions between the two groups were compared.3 ml venous blood was taken from the patients before and after treatment on an empty stomach,and MMP-9 level was detected by enzyme-linked immunosorbent assay and compared between the two groups.Results:After treatment,the total effective rate of group A(91.84%)was significantly higher than that of group B(73.58%)with statistically significant.After treatment,the quantitative levels of the renal function indexes SCr,BUN,β2-MG and 24-hour urine protein between the two groups were lower than those before treatment.The serum MMP-9 levels and the quality of life levels were significantly higher than those before treatment.Moreover,the quantitative levels of SCr,BUN,β2-MG and 24-hour urine protein in group A were significantly lower than those of group B,and the levels of the serum MMP-9 and quality of life were significantly higher than that of group B(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The combination of tripterygium glycosides and valsartan has a significant effect in the treatment of CGN patients,and increasing the initial dose of tripterygium glycosides can effectively improve the patient’s renal function,improve clinical efficacy and quality of life.Its internal mechanism may be associated with a more effective increase in the level of MMP-9 with greater safety.