贵州医科大学学报

2018, v.43;No.218(11) 1336-1339

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环磷酰胺联合糖皮质激素对原发性肾病综合征患者肾功能和血脂的影响
Influence of Cyclophosphamide Combined with Glucocorticoid on Renal Function and Blood lipids in Treatment of Primary Nephrotic Syndrome

朱莉;邵维斌;夏春英;丁浩;
ZHU Li;SHAO Weibin;XIA Chunying;DING Hao;Department of Nephrology,the Affiliated People's Hospital of Jiangsu University;

摘要(Abstract):

目的:探讨环磷酰胺联合糖皮质激素对原发性肾病综合征(PNS)患者肾功能和血脂的影响。方法:112例PNS患者,随机均分为实验组和对照组,对照组给予糖皮质激素治疗,实验组在对照组治疗的基础上加用环磷酰胺治疗;比较治疗前及治疗12月时2组患者血清尿素氮(BUN)、白蛋白(Alb)、血肌酐(Scr)、24 h尿蛋白定量(24Upro)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、脂蛋白a(LPa)、载脂蛋白A1(Apo A1)、载脂蛋白B(Apo B)水平及尿量,记录治疗期间2组患者的不良反应。结果:治疗前,2组患者肾功能及血脂代谢指标比较,差异无统计学意义(P> 0. 05);治疗12月时2组患者血清BUN、24Upro、TC、TG、LDL、LPa、Apo B水平均较治疗前显著降低,Alb、Scr水平、尿量较治疗前显著升高,实验组变化更明显(P <0. 05,或P <0. 01); 2组患者HDL、Apo A1水平较治疗前无明显变化(P> 0. 05); 2组患者总不良反应发生率比较,差异无统计学意义(χ2=2. 842,P=0. 092)。结论:糖皮质激素联合环磷酰胺可明显改善PNS患者肾功能及血脂代谢紊乱状态,效果优于单独糖皮质激素治疗。
Objective: To investigate the effect of cyclophosphamide combined with glucocorticoid on renal functions and blood lipids in patients with primary nephrotic syndrome(PNS). Methods: 112 patients with PNS in our hospital from April 2015 to January 2018 were selected and randomly divided into the experiment group and the control group,with 56 cases in each group. The control group was given glucocorticoid treatment,and the experiment group was added with cyclophosphamide on the basis of the treatment for the control group. Both groups were treated for 12 months. The changes of renal function and blood lipid metabolism indexes before and after treatment were compared between the 2 groups,and their incidence of adverse reactions was calculated. Results: Compared with before treatment,the levels of serum BUN and 24 Upro of both groups after treatment decreased significantly,and the experiment group's level was significantly lower than the control group's(P < 0. 01); their levels of Alb,Scr and urine volume increased significantly,and the experiment group's change was more obvious(P < 0. 05 or P < 0. 01). The levels of TC,TG,LDL,LPa and ApoB of the 2 groups in peripheral blood after treatment decreased significantly,and the experiment group 's levels were significantly lower than the controls'(P < 0. 05 or P < 0. 01). There was no significant change in the levels of HDL and ApoA1 in the 2 groups(P > 0. 05). The incidence of total adverse reactions in the experiment group had no significant increase compared with the control group(P < 0. 05). Conclusion: Glucocorticoid combined with cyclophosphamide can significantly improve renal functions and lipid metabolism disorder in patients with PNS. Its efficacy is better than glucocorticoid treatment alone,and it does not increase the incidence of adverse reactions.

关键词(KeyWords): 环磷酰胺;糖皮质激素;原发性肾病综合征;肾功能;血脂
cyclophosphamide;glucocorticoid;primary nephrotic syndrome;renal function;blood lipids

Abstract:

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基金项目(Foundation): 镇江市社会发展项目SH2013045

作者(Author): 朱莉;邵维斌;夏春英;丁浩;
ZHU Li;SHAO Weibin;XIA Chunying;DING Hao;Department of Nephrology,the Affiliated People's Hospital of Jiangsu University;

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DOI: 10.19367/j.cnki.1000-2707.2018.11.020

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