他克莫司联合激素治疗对IgA肾病伴黏膜感染患者血清VEGF和ET-1水平的影响

发布时间：2018-08-27 09:37

【摘要】：目的探讨他克莫司联合泼尼松应用于进展型IgA肾病伴黏膜感染患者的疗效及血清血管内皮生长因子(VEGF)和内皮素-1(ET-1)水平影响的研究。方法选取2012年7月-2016年7月于医院肾内科进行治疗的50例进展型IgA肾病伴黏膜感染患者,按照随机数字表法分为试验组与对照组,每组各25例,两组均予血管紧张素转化酶抑制剂(ACEI)/血管紧张素受体拮抗剂(ARB)等常规治疗,对照组给予泼尼松治疗;试验组联合应用他克莫司和小剂量泼尼松治疗。观察两组患者治疗前后血清Cr、24h尿蛋白定量(PRO)、胱抑素C(CysC)、VEGF、ET-1和白介素18(IL-18)、细胞间黏附分子-1(ICAM-1)水平和临床疗效变化情况。结果治疗后,两组24hPRO、CysC、VEGF、ET-1和IL-18、ICAM-1水平均比治疗前降低(P0.05);试验组24hPRO、CysC、VEGF、ET-1和IL-18、ICAM-1水平较对照组低(P0.05),试验组总有效率91.67%高于对照组的75.00%(P0.05)。结论他克莫司联合泼尼松能有效降低IgA肾病伴黏膜感染患者血清VEGF、ET-1水平,减少蛋白尿,改善肾功能,具有较高的临床疗效。
[Abstract]:Objective to investigate the effect of tacrolimus combined with prednisone on progressive IgA nephropathy with mucosal infection and the effects of serum vascular endothelial growth factor (VEGF) and endothelin-1 (ET-1) levels. Methods from July 2012 to July 2016, 50 patients with advanced IgA nephropathy accompanied with mucosal infection were selected and divided into two groups: experimental group (n = 25) and control group (n = 25). Both groups were treated with angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor antagonist (ARB), while the control group were treated with prednisone, and the experimental group was treated with tacrolimus and low-dose prednisone. Before and after treatment, the levels of serum Cr,24h urinary protein (Cr,24h), (PRO), cystatin (C (CysC) and interleukin-18 (IL-18), intercellular adhesion molecule-1 (ICAM-1) and clinical efficacy were observed. Results after 24 h treatment, the levels of IL-18,ICAM-1 and VEGFET-1 in the two groups were lower than those in the control group (P0.05), while the levels of procylla CysCy VEGFET-1 and IL-18,ICAM-1 in the experimental group were lower than those in the control group (P0.05). The total effective rate of the experimental group was 91.67% higher than that of the control group (75.00%, P0.05). Conclusion tacrolimus combined with prednisone can effectively reduce the level of serum VEGF,ET-1, reduce proteinuria and improve renal function in patients with IgA nephropathy with mucosal infection.
【作者单位】：温州医科大学附属第三医院肾内科;
【基金】：温州市科技计划基金资助项目(Y20170299)
【分类号】：R692.31

【相似文献】