泼尼松联合碳酸氢钠及别嘌呤醇治疗免疫球蛋白A肾病合并高尿酸血症的疗效评估

Evaluation of prednisone combined with sodium bicarbonate and allopurinol in the treatment of immunoglobulin A nephropathy with hyperuricemia

目的探讨泼尼松联合碳酸氢钠及别嘌呤醇治疗免疫球蛋白A(IgA)肾病合并高尿酸血症的临床疗效。方法选取2016年1月至2020年12月本院收治的80例IgA肾病合并高尿酸血症患者作为研究对象,按照不同的治疗方案分为单一组与联合组,每组40例。单一组予以泼尼松治疗,联合组予以泼尼松联合碳酸氢钠及别嘌呤醇治疗,比较两组血肌酐(Scr)、24 h尿蛋白定量(UTP)、血尿酸(UA)、肾小球滤过率(GFR)及血脂水平。结果治疗后2个月,联合组Scr、UA、UTP、GFR水平均低于单一组,差异有统计学意义(P<0.05)。治疗后,联合组总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平均低于单一组,高密度脂蛋白胆固醇(HDL-C)高于单一组,差异有统计学意义(P<0.05)。结论泼尼松联合碳酸氢钠及别嘌呤醇治疗IgA肾病合并高尿酸血症患者效果显著,可有效降低患者尿酸与血脂水平,防止肾功能受到进一步的损害,值得临床推广应用。

Objective To explore the clinical efficacy of prednisone combined with sodium bicarbonate and allopurinol in the treatment of immunoglobulin A(IgA)nephropathy with hyperuricemia.Methods 80 patients with IgA nephropathy complicated with hyperuricemia admitted to our hospital from January 2016 to December 2020 were selected as the study subjects,and they were divided into single group and combined group according to different treatment regimen,with 40 cases in each group.The single group was treated with prednisone,and the combined group was treated with prednisone combined with sodium bicarbonate and allopurinol.Serum creatinine(Scr),24 h urinary protein quantity(UTP),blood uric acid(UA),glomerular filtration rate(GFR)and blood lipid levels were compared between the two groups.Results After 2 months of treatment,the levels of Scr,UA,UTP,and GFR in the combined group were lower than those in the single group,the differences were statistically significant(P<0.05).After treatment,the levels of total cholesterol(TC),triglyceride(TG),and low density lipoprotein cholesterol(LDL-C)in the combined group were lower than those in the single group,while the level of high-density lipoprotein cholesterol(HDL-C)was higher than that in the single group,the difference was statistically significant(P<0.05).Conclusion Prednisone combined with sodium bicarbonate and allopurinol in the treatment of IgA nephropathy patients with hyperuricemia has significant effect,can effectively reduce the levels of uric acid and blood lipid,prevent further damage to renal function,and is worthy of clinical promotion and application.