活瘀祛浊益气方联合泼尼松+他克莫司对特发性膜性肾病患者血清抗PLA2R抗体及氧化应激指标的影响

Effect of Huoyu Quzhuo Yiqi Decoction combined with prednisone and tacrolimus on serum anti-PLA2R antibody and oxidative stress indicators in patients with idiopathic membranous nephropathy

目的探讨活瘀祛浊益气方联合泼尼松+他克莫司治疗对特发性膜性肾病患者血清抗磷脂酶A2受体(PLA2R)抗体及氧化应激指标的影响。方法选取2022年2~7月宝鸡高新医院肾病内科收治的60例特发性膜性肾病患者作为研究对象,采用随机数表法将患者分为对照组和观察组,每组30例。对照组患者采用泼尼松联合他克莫司治疗,观察组患者采用活瘀祛浊益气方联合泼尼松和他克莫司治疗,两组患者均连续治疗6个月。比较两组患者治疗后的血清抗PLA2R抗体阴性情况,以及治疗前后的尿蛋白定量(U-Pro)、血清白蛋白(ALB)、血肌酐(SCr)及氧化应激指标水平。结果治疗后,观察组患者的血清抗PLA2R抗体转阴率为96.67%,明显高于对照组的80.00%,差异具有统计学意义(P<0.05);治疗后,观察组患者的U-Pro、SCr水平分别为(1526.47±135.29)mg/g、(110.24±13.25)μmol/L,明显低于对照组的(1749.42±178.44)mg/g、(130.89±18.57)μmol/L,ALB水平为(32.86±4.31)g/L,明显高于对照组的(29.58±2.77)g/L,差异均具有统计学意义(P<0.05);治疗后,观察组患者的一氧化氮(NO)、超氧化物歧化酶(SOD)水平分别为(67.33±5.89)mol/mL、(87.48±1.94)IU/mL,明显高于对照组的(61.72±4.21)mol/mL、(76.26±1.58)IU/mL,丙二醛(MDA)含量为(4.22±0.39)mmol/L,明显低于对照组的(4.78±0.89)mmol/L,差异均具有统计学意义(P<0.05)。结论活瘀祛浊益气方联合泼尼松+他克莫司治疗可有效提升特发性膜性肾病患者血清抗PLA2R抗体转阴率,保护肝肾功能,减少氧化应激反应。

Objective To explore the effect of Huoyu Quzhuo Yiqi Decoction combined with prednisone and tacrolimus treatment on serum anti-phospholipase A2 receptor(PLA2R)antibody and oxidative stress indicators in patients with idiopathic membranous nephropathy(IMN).Methods A total of 60 patients with IMN admitted to Department of Nephrology,Baoji High-tech Hospital from February 2022 to July 2022 were selected and divided into control group and observation group by random number table method,with 30 cases in each group.Patients in the control group were treated with prednisone and tacrolimus,while those in the observation group were treated with Huoyu Quzhuo Yiqi Decoction combined with prednisone and tacrolimus.After 6 months of continuous treatment,the negative conversion of serum anti-PLA2R antibody,urine protein quantity(U-Pro),serum albumin(ALB),serum creatinine(SCr),and oxidative stress indicators were compared between the two groups.Results After treatment,the negative conversion rate of serum anti-PLA2R antibody in the observation group(96.67%)was significantly higher than that in the control group(80.00%),P<0.05.The levels of U-Pro and SCr in the observation group were(1526.47±135.29)mg/g and(110.24±13.25)μmol/L,significantly lower than(1749.42±178.44)mg/g and(130.89±18.57)μmol/L in the control group;the level of ALB was(32.86±4.31)g/L in the observation group,significantly higher than(29.58±2.77)g/L in the control group;the differences were statistically significant(P<0.05).The levels of nitric oxide(NO)and superoxide dismutase(SOD)in the observation group were(67.33±5.89)mol/mL and(87.48±1.94)IU/mL,significantly higher than(61.72±4.21)mol/mL and(76.26±1.58)IU/mL in the control group;the level of malondialdehyde(MDA)was(4.22±0.39)mmol/L in the observation group,significantly lower than(4.78±0.89)mmol/L in the control group;the differences were statistically significant(P<0.05).Conclusion Huoyu Quzhuo Yiqi Decoction combined with prednisone and tacrolimus treatment can effectively improve the negative conversion rate of serum anti-PLA2R antibody in patients with IMN,protect their liver and kidney function,and reduce oxidative stress.