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目的比较雷公藤多甙联合血管紧张素受体拮抗剂(ARB)与单独应用ARB治疗中等量蛋白尿IgA肾病的疗效。方法纳入2014年1月至2015年12月期间于中国医科大学附属第一医院肾内科住院治疗的原发性IgA肾病患者,24 h尿蛋白定量为1.0~3.5 g,且肾功能正常,行雷公藤多甙联合ARB治疗者30例,同时选取同时期ARB单独治疗者30例为对照组。比较两组治疗前后临床指标以及两组间的临床缓解率。结果两组患者的一般临床病理特征比较差异无统计学意义。两组患者经6个月治疗后尿蛋白、血清白蛋白均明显改善(P均<0.05),肾功能稳定。联合治疗组临床缓解率明显高于ARB治疗组(P<0.05)。结论雷公藤多甙联合ARB能明显减少中等量蛋白尿IgA肾病患者的蛋白尿,改善血清白蛋白水平,稳定肾功能。
Objective To compare the efficacy of tripterygium glycosides combined with angiotensin receptor blocker (ARB) and ARB alone in the treatment of moderate proteinuria and IgA nephropathy. Methods Patients with idiopathic IgA nephropathy hospitalized in the Department of Nephrology, the First Affiliated Hospital of China Medical University from January 2014 to December 2015 were enrolled in this study. The 24-hour urine protein was 1.0-3.5 g and had normal renal function. Thirty polyglucosides combined ARB treatment in 30 cases, while the same period selected ARB monotherapy in 30 cases as control group. The clinical indexes before and after treatment and the clinical remission rate between the two groups were compared. Results There was no significant difference in the general clinicopathological features between the two groups. Urine protein and serum albumin were significantly improved in both groups after 6 months (P <0.05), and renal function was stable. The remission rate in combination therapy group was significantly higher than that in ARB treatment group (P <0.05). Conclusion Tripterygium glycosides combined with ARB can significantly reduce proteinuria in patients with moderate proteinuria of IgA nephropathy, improve serum albumin levels and stabilize renal function.