不同治疗方案对老年特发性膜性肾病的疗效比较

A Comparative Study on the Curative Effect of Different Treatment Regimens for Senile Idiopathic Membranous Nephropathy

目的:探讨不同治疗方案在老年特发性膜性肾病(IMN)中的临床疗效及安全性。方法:选取2019年1月-2020年12月新余市人民医院收治的老年IMN患者90例,按随机数字表法分为三组,各30例。对照组予以非免疫抑制治疗,观察1组予以环磷酰胺联合足量泼尼松治疗,观察2组予以环孢素A联合小剂量泼尼松治疗。比较三组临床疗效、临床生化指标、不良反应发生情况。结果:观察2组与观察1组缓解率相比,差异无统计学意义(P>0.05);观察2组、观察1组缓解率均高于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组2与观察1组白蛋白水平、尿蛋白定量比较,差异均无统计学意义(P>0.05);观察2组、观察1组白蛋白水平均高于对照组,尿蛋白定量均低于对照组,差异均有统计学意义(P<0.05)。观察2组不良反应发生率低于观察1组,差异有统计学意义(P<0.05)。结论:环孢素A联合小剂量泼尼松治疗老年IMN效果更佳,能提高疾病缓解率,降低尿蛋白定量,加快血清白蛋白水平复常,安全可靠。

Objective:To investigate the clinical efficacy and safety of different treatment regimens in senile idiopathic membranous nephropathy (IMN).Method:A total of 90 elderly patients with IMN admitted to Xinyu People’s Hospital from January 2019 to December 2020 were selected and divided into three groups by random number table method,with 30 cases in each group.The control group was treated with non-immunosuppressive therapy,the observation group 1 was treated with Cyclophosphamide combined with full-dose Prednisone,and the observation group 2 was treated with Cyclosporine A combined with low-dose Prednisone.The clinical efficacy,clinical biochemical indexes and adverse reactions of the three groups were compared.Result:There was no significant difference in the remission rate between observation group 2 and observation group 1 (P>0.05);the remission rates of observation group 2 and observation group 1 were higher than that of the control group,the differences were statistically significant (P<0.05).After treatment,there were no significant differences in albumin level and urine protein quantitation between observation group 2 and observation group 1 (P>0.05);the levels of albumin in observation group 2 and observation group 1 were higher than that in the control group,and the urine protein quantitation were lower than that in the control group,the differences were statistically significant (P<0.05).The incidence of adverse reactions in observation group 2 was lower than that in observation group 1,the difference was statistically significant (P<0.05).Conclusion:Cyclosporine A combined with low-dose Prednisone is more effective in the treatment of senile IMN,which can improve the remission rate of disease,reduce the quantity of urinary protein and accelerate the recovery of serum albumin level,which is safe and reliable.