羟氯喹联合肾素-血管紧张素系统抑制剂(RASI)对IgA肾病减少蛋白尿的回顾性研究

Retrospective Study on the Effect of Hydroxychloroquine Combined with Renin-angiotensin System Inhibitor (RASI) on Reducing Proteinuria in IgA Nephropathy

目的 探讨羟氯喹联合肾素-血管紧张素系统抑制剂(RASI)对IgA肾病治疗减少蛋白尿的临床研究。方法 回顾性分析本院2020年10月至2021年12月收治的60例Ig A肾病患者,按照两组患者治疗方案分组,其中对照组(n=37)采用RASI药物治疗,观察组(n=23)采用羟氯喹联合RASI治疗。对患者保持至少6个月的随访,对比两组患者尿蛋白、肌酐、血管紧张素Ⅱ、IgA指标变化;同时统计两组患者终点事件发生情况、不良反应发生率。结果 治疗前两组患者的尿蛋白、肌酐、血管紧张素Ⅱ、IgA指标水平对比差异不显著(P> 0.05);治疗3个月观察组尿蛋白、血管紧张素Ⅱ、IgA指标水平低于对照组(P <0.05),治疗3个月两组肌酐水平对比差异不显著(P> 0.05);治疗6个月两组肌酐、血管紧张素Ⅱ、IgA对比差异不显著(P> 0.05),治疗6个月观察组尿蛋白水平低于对照组(P <0.05)。随访中,观察组进展为肾衰竭的患者占比少于对照组,对比差异显著(P <0.05)。两组患者不良反应对比,差异不显著(P> 0.05)。结论 在IgA肾病患者的治疗中,采用羟氯喹联合RASI的治疗方案,可有效降低患者尿蛋白水平,从而控制肾病的进展,对患者的远期预后产生积极影响。

Objective To investigate the clinical study of hydroxychloroquine combined with renin-angiotensin system inhibitor(RASI) in the treatment of IgA nephropathy to reduce proteinuria.Methods Retrospective analysis was made on 60 patients with IgA nephropathy admitted from October 2020 to December 2021 in our hospital.The patients were divided into two groups according to the treatment scheme.The control group(n=37)was treated with RASI drugs,and the observation group(n=23) was treated with hydroxychloroquine combined with RASI.The patients were followed up for at least 6 months,and the changes of urinary protein,creatinine,angiotensin Ⅱ and IgA were compared between the two groups;At the same time,the incidence of endpoint events and adverse reactions in the two groups were counted.Results There was no significant difference in the levels of urinary protein,creatinine,angiotensin Ⅱ and IgA between the two groups before treatment(P>0.05);After 3 months of treatment,the levels of urinary protein,angiotensin Ⅱ and IgA in the observation group were lower than those in the control group(P0.05);After 6 months of treatment,there was no significant difference between the two groups in creatinine,angiotensin Ⅱ and IgA(P>0.05).After 6 months of treatment,the urine protein level in the observation group was lower than that in the control group(P0.05).Conclusion In the treatment of patients with IgA nephropathy,hydroxychloroquine combined with RASI can effectively reduce the level of urine protein in patients,so as to control the progress of nephropathy and have a positive impact on the long-term prognosis of patients.