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目的研究雷公藤多苷治疗IgA肾病患者的临床疗效。方法将40例IgA肾病患者视为试验组,用雷公藤多苷1 mg·kg~(-1)·d~(-1),分3次口服,治疗6个月。另取同期在本院进行健康体检的40例研究对象作为对照组,对照组不做任何处理。用酶联免疫吸附法检测2组患者血清白细胞介素-15(IL-15)、白细胞介素-18(IL-18)水平。分析患者临床疗效,测定2组研究对象血脂及24h尿蛋白沉淀定量指标。结果治疗后,试验组的总有效率达90.00%(36/40例)。治疗前,试验组与对照组的血清IL-15、IL-18水平分别为(79.47±7.46),(344.14±21.49)ng·L~(-1);(61.91±4.88),(95.70±6.78)ng·L~(-1),与对照组比较,差异均有统计学意义(均P<0.05)。治疗后,试验组的血清IL-15、IL-18水平分别为(61.76±6.98),(94.49±8.73)ng·L~(-1),与对照组比较,差异均无统计学意义(均P>0.05)。治疗前,试验组与对照组的尿红细胞计数、24 h尿蛋白定量分别为(153.00±10.33),(101.30±7.67)per·μL~(-1);(1.99±0.17),(0.48±0.04)g·d~(-1)。对照组比较,差异均有统计学意义(均P<0.05)。治疗后,试验组的尿红细胞计数、24 h尿蛋白定量分别为(103.16±7.54)per·μL~(-1),(0.51±0.04)g·d~(-1)。与治疗前相比,差异均有统计学意义(均P<0.05);与对照组相比,差异均无统计学意义(均P>0.05)。结论雷公藤多苷用于IgA肾病患者中,能有效降低患者血清的IL-15、IL-18水平,改善患者临床症状,且安全性良好。
Objective To study the clinical efficacy of tripterygium glycosides in patients with IgA nephropathy. Methods 40 patients with IgA nephropathy were considered as the experimental group, with Tripterygium glycosides glycosides 1 mg · kg -1 (-1), three times orally for 6 months. Another take the same period in our hospital for physical examination of 40 subjects as a control group, the control group without any treatment. Serum levels of interleukin-15 (IL-15) and interleukin-18 (IL-18) were measured by enzyme-linked immunosorbent assay. The clinical curative effect of the patients was analyzed, and the serum lipids and the quantitative indexes of 24h urinary protein deposition in two groups were determined. Results After treatment, the total effective rate of the experimental group was 90.00% (36/40 cases). Before treatment, the serum levels of IL-15 and IL-18 in the test group and the control group were (79.47 ± 7.46), (344.14 ± 21.49) ng · L -1, (61.91 ± 4.88), (95.70 ± 6.78 ) ng · L ~ (-1), the differences were statistically significant (all P <0.05) compared with the control group. After treatment, the serum levels of IL-15 and IL-18 in the experimental group were (61.76 ± 6.98) and (94.49 ± 8.73) ng · L -1, respectively, which were not significantly different from those in the control group P> 0.05). Before treatment, urinary erythrocyte count and urinary protein in 24 h group were (153.00 ± 10.33), (101.30 ± 7.67) per · μL -1; (1.99 ± 0.17), (0.48 ± 0.04) ) g · d ~ (-1). The difference between the two groups was statistically significant (all P <0.05). After treatment, urinary erythrocyte count and urinary protein in the experimental group were (103.16 ± 7.54) per · μL -1, (0.51 ± 0.04) g · d -1, respectively. Compared with those before treatment, the differences were statistically significant (all P <0.05). There was no significant difference between the two groups (all P> 0.05). Conclusion Tripterygium glycosides used in patients with IgA nephropathy, can effectively reduce the serum IL-15, IL-18 levels, improve clinical symptoms, and good safety.