雷公藤多苷联合激素对成人NS糖皮质激素抵抗及HSP90的影响

发布时间：2018-05-27 10:10

本文选题：成人肾病综合征 + 雷公藤多苷　；参考：《基因组学与应用生物学》2017年11期

【摘要】：为探讨雷公藤多苷联合激素治疗成人肾病综合征(NS)的临床效果及对患者糖皮质激素抵抗、热休克蛋白90(HSP90)表达的影响,本研究将82例肾病综合征患者按随机数字表法分为对照组与观察组两组,每组41例,两组均予以基础对症处理,对照组采用糖皮质激素泼尼松治疗,1 mg/kg,8周或尿蛋白阴转2周后逐渐减量,维持20 mg/d,观察组加用雷公藤多苷片治疗,20 mg/次,3次/d,共治疗24周。并将观察组与对照组比较,结果发现,观察组治疗总有效率高于对照组(p0.05),且治疗后,两组尿蛋白定量降低,总蛋白(TP)、血清白蛋白(ALB)均上升,与同组治疗前对比差异有统计学意义(p0.05),观察组尿蛋白定量降低幅度、TP及ALB上升幅度高于对照组(p0.05);且观察组血肌酐(Cr)、尿素氮(BUN)、糖皮质激素受体β(GRβ)、HSP90均降低,与同组治疗前及对照组治疗后对比差异有统计学意义(p0.05);同时观察组不良反应发生率略低于对照组,但未见统计学差异。对成人NS患者采用雷公藤多苷联合糖皮质激素治疗较单纯激素治疗总有效率高,且可明显改善患者肾功能及糖皮质激素抵抗,下调HSP90表达。
[Abstract]:To investigate the clinical effect of tripterygium wilfordii polyglycoside combined with hormone in the treatment of adult nephrotic syndrome (NS) and its effect on glucocorticoid resistance and heat shock protein 90 (HSP90) expression. In this study, 82 patients with nephrotic syndrome were randomly divided into control group and observation group with 41 cases in each group. The control group was treated with glucocorticoid prednisone for 8 weeks or urine protein negative for 2 weeks. The control group was treated with tripterygium wilfordii polyglycosides for 20 mg/ d for 24 weeks. Compared with the control group, the total effective rate in the observation group was higher than that in the control group (P 0.05). Compared with the same group before treatment, the difference was statistically significant (p 0.05). The increase of TP and ALB in the observation group was higher than that in the control group, and the levels of creatinine, bun, glucocorticoid receptor 尾 -gr 尾 -HSP90 were decreased in the observation group, and the levels of serum creatinine, bun and glucocorticoid receptor 尾 -gr 尾 -HSP90 in the observation group were lower than those in the control group. The incidence of adverse reactions in the observation group was slightly lower than that in the control group, but there was no statistical difference between the observation group and the control group. The total effective rate of tripterygium wilfordii polyglycoside combined with glucocorticoid was higher than that of single hormone therapy, and the renal function and glucocorticoid resistance of the patients were significantly improved, and the expression of HSP90 was down-regulated.
【作者单位】：邢台市人民医院肾内科;邢台市人民医院超声科;
【基金】：多靶点治疗对难治性成人肾病综合征肾功能的临床研究、邢台市人民医院资助
【分类号】：R692

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