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本研究的为探讨雷公藤多甙联合福辛普利治疗小儿过敏性紫癜性肾炎(Henoch-Schonlein purpura nephritis,HSPN)的临床疗效及相关机制。选取2013年1月~2015年1月收入我院的94例过敏性紫癜性肾炎患儿,根据随机数字表法分为对照组和观察组,各47例。两组患者均给予常规内科治疗,对照组患儿在此基础上给予福辛普利钠,观察组患儿在对照组的基础上给予雷公藤多甙片。比较两组患儿的临床资料。治疗后,比较两组患儿免疫球蛋白水平、PT、APPT、PLT、FIB水平的变化情况。观察组的总有效率显著高于对照组,且复发率显著低于对照组(p<0.05)。观察组的收缩压、舒张压、24 h尿蛋白量及腹痛、关节疼痛和水肿消失时间等临床症状的改善均显著优于对照组(p<0.05)。治疗后,两组患者Ig A水平均显著降低(p<0.05),且观察组较对照组降低更明显(p<0.05);对照组PT较治疗前无明显改变(p>0.05),而观察组PT则显著升高(p<0.05),组间比较差异显著(p<0.05);两组患者PLT较治疗前均显著降低(p<0.05),且观察组较对照组降低更明显,组间比较差异显著(p<0.05)。雷公藤多甙联合福辛普利对小儿HSPN临床疗效较好,可显著改善患者症状,其机制可能与降低Ig A水平、抑制细胞免疫、升高PT、降低PLT计数,以及改善凝血功能相关。
This study was designed to investigate the clinical effects and mechanisms of tripterygium glycosides combined with fosinopril in the treatment of children with Henoch-Schonlein purpura nephritis (HSPN). A total of 94 children with allergic purpura nephritis who were admitted to our hospital from January 2013 to January 2015 were divided into control group and observation group according to random number table method, 47 cases in each group. Two groups of patients were given conventional medical treatment, children in the control group on the basis of given fosinopril sodium, the observation group were given control group based on the tripterygium glycosides tablets. The clinical data of two groups were compared. After treatment, immunoglobulin levels, PT, APPT, PLT, FIB levels were compared between the two groups. The total effective rate in the observation group was significantly higher than that in the control group, and the recurrence rate was significantly lower than that in the control group (p <0.05). The clinical symptoms such as systolic blood pressure, diastolic blood pressure, 24 h urinary protein, abdominal pain, joint pain and edema disappeared in the observation group were significantly better than those in the control group (p <0.05). After treatment, the levels of IgA in both groups were significantly decreased (p <0.05), and the observation group was more significantly reduced than the control group (p <0.05); PT in the control group had no significant change (p> 0.05) (P <0.05). There was significant difference between the two groups (p <0.05). The PLT of both groups was significantly lower than that before treatment (p <0.05), and the observation group was more obvious than the control group The difference was significant (p <0.05). Tripterygium glycosides combined with fosinopril in children with HSPN better curative effect, can significantly improve the patient’s symptoms, the mechanism may be associated with lower IgA levels, inhibition of cellular immunity, increased PT, decreased PLT count, and improve coagulation.