贝前列素钠联合他克莫司治疗原发性肾病综合征的临床效果及对NLRP3炎症小体的影响

Clinical effect of beraprost sodium combined with tacrolimus in the treatment of primary nephrotic syndrome and its influence on NLRP3 inflammasome

目的探究贝前列素钠联合他克莫司治疗原发性肾病综合征(PNS)的临床效果及对核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)炎症小体的影响。方法选择2019年10月至2020年11月我院收治的124例PNS患者,按照随机数字表法将其分为治疗组(62例,贝前列素钠片联合他克莫司胶囊)及对照组(62例,他克莫司胶囊)。比较两组的临床效果。结果治疗后,两组的NLRP3、凋亡相关斑点样蛋白(ASC)、半胱氨酸蛋白酶-1(Caspase-1)蛋白、白细胞介素-18(IL-18)、白细胞介素-1β(IL-1β)水平均降低,且治疗组低于对照组(P<0.01)。治疗后,两组的血肌酐(Scr)、尿素氮(BUN)水平及24 h尿蛋白定量(24 h UPQ)均降低,白蛋白(ALB)水平均升高,且治疗组优于对照组(P<0.01)。治疗组的治疗总有效率显著高于对照组(P=0.023)。两组的不良反应总发生率无显著差异(P>0.05)。治疗组的复发率低于对照组(P=0.012)。结论贝前列素钠联合他克莫司治疗PNS具有较好的效果,可明显改善患者的临床症状,提高肾功能,降低疾病复发率,这可能与其有效抑制NLRP3介导的炎症反应密切相关。

Objective To explore the clinical effect of beroprost sodium combined with tacrolimus in the treatment of primary nephrotic syndrome(PNS)and its influence on nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)inflammasome.Methods A total of 124 PNS patients admitted in our hospital from October 2019 to November 2020 were selected and divided into treatment group(62 cases,beraprost sodium tablets combined with tacrolimus capsules)and control group(62 cases,tacrolimus capsules)according to the random number table method.The clinical effects of the two groups were compared.Results After treatment,the levels of NLRP3,apoptosis-associated speck-like protein containing a CARD(ASC),Caspase-1 protein,interleukin-18(IL-18)and interleukin-1β(IL-1β)in the two groups decreased,and those in the treatment group were lower than the control group(P<0.01).After treatment,the levels of serum creatinine(Scr),blood urea nitrogen(BUN)and 24 h urinary protein quantification(24 h UPQ)in the two groups decreased,while the level of albumin(ALB)increased,and those in the treatment group were better than the control group(P<0.01).The total effective rate of treatment in the treatment group was significantly higher than that in the control group(P=0.023).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).The recurrence rate of the treatment group was lower than that in the control group(P=0.012).Conclusion Beroprost sodium combined with tacrolimus in the treatment of PNS has good curative effect,it can significantly ameliorate the clinical symptoms of patients,improve renal function,and reduce the recurrence rate of diseases,which may be closely related to its effective inhibition of NLRP3-mediated inflammatory response.