小剂量吗替麦考酚酯联合缬沙坦治疗IgA肾病的临床疗效分析

Clinical Analysis of Low-dose Mycophenolate Mofetil Combined with Valsartan in the Treatment of IgA Nephropathy

目的分析小剂量吗替麦考酚酯联合缬沙坦治疗IgA肾病的临床疗效。方法选取2016年1月—2021年6月在该院经肾穿刺活检并结合临床确诊为原发性IgA肾病的患者72例为研究对象。根据治疗方案的不同分为研究组和对照组,各36例,对照组采用缬沙坦联合甲泼尼龙治疗,研究组在对照组的基础上联合吗替麦考酚酯治疗。观察两组患者治疗前后24 h尿蛋白定量、血清白蛋白(ALB)、血肌酐(Scr)、尿素氮(UN)、总胆固醇(TC)水平,并观察两组的临床疗效及不良反应发生情况。结果治疗前,研究组的尿蛋白、ALB、Scr、UN、TC与对照组比较,差异无统计学意义(P>0.05);治疗后,研究组与对照组的尿蛋白、ALB、Scr、UN、TC均有所改善,且研究组较对照组显著,差异有统计学意义(P<0.05)。研究组的总有效率为97.22%,明显高于对照组77.78%,差异有统计学意义(χ^(2)=6.222,P<0.05)。研究组的不良反应发生率较对照组低,差异有统计学意义(P<0.05)。结论吗替麦考酚酯联合缬沙坦及小剂量糖皮质激素治疗IgA肾病能获得较好的临床效果,能显著控制尿蛋白、稳定肾功能,不良反应较少,值得临床广泛应用。

Objective To analyse the clinical efficacy of low-dose mycophenolate mofetil combined with valsartan in the treatment of IgA nephropathy.Methods A total of 72 patients with primary IgA nephropathy who underwent renal biopsy in the hospital from January 2016 to June 2021 were selected as the research objects.According to the different treatment plans,they were divided into the study group and the control group,with 36 cases in each group.The control group was treated with valsartan combined with methylprednisolone,and the study group was treated with mycophenolate mofetil on the basis of the control group.The 24 h urine protein quantitative,serum albumin(ALB),serum creatinin(Scr),urea nitrogen(UN)and total cholesterol(TC)levels were observed before and after treatment in the two groups.The clinical efficacy and adverse reactions of the two groups were observed.Results Before treatment,there was no statistically significant difference in urinary protein,ALB,Scr,UN,TC between the study group and the control group(P>0.05).After treatment,the urinary protein,ALB,Scr,UN and TC of the study group and the control group were improved,and the study group was significantly better than the control group,and the difference was statistically significant(P<0.05).The total effective rate of the study group was 97.22%,which was significantly higher than that of the control group(77.78%),and the difference was statistically significant(χ^(2)=6.222,P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Mycophenolate mofetil combined with valsartan and low-dose glucocorticoids can achieve good clinical effect in the treatment of IgA nephropathy.It can significantly control urinary protein,stabilize renal function,and have few adverse reactions,which is worthy of wide clinical application.