雷公藤多苷联合科素亚对老年IgA肾病患者的临床疗效及对TGF-β1、PAI-1及VEGF表达的影响

发布时间：2018-10-24 13:12

【摘要】：目的观察雷公藤多苷联合科素亚治疗老年IgA肾病(IgAN)的临床疗效及其对转化生长因子β1(TGF-β1)、纤溶酶原激活物抑制物-1(PAI-1)及血管内皮生长因子(VEGF)表达的影响。方法选取2011年4月至2016年1月武警浙江总队嘉兴医院收治的老年IgA患者80例,随机分为对照组与观察组,各40例。两组患者均常规治疗慢性基础病并口服科素亚,观察组在此基础上口服雷公藤多苷,连续12个月。比较两组治疗前及治疗3、6、12个月尿蛋白、血肌酐(Scr)、尿素氮(BUN)、血浆清蛋白(Alb)、尿TGF-β1、PAI-1及VEGF水平,记录患者不良反应发生情况。结果治疗后3、6、12个月,两组24h尿蛋白水平较治疗前均下降,且各时间点观察组24h尿蛋白水平均低于对照组,差异均有统计学意义(P0.05)。治疗后,两组Scr、BUN水平及尿TGF-β1、PAI-1、VEGF水平均较治疗前降低,Alb水平较治疗前升高,且观察组Scr、BUN水平及尿TGF-β1、PAI-1、VEGF水平均低于对照组,Alb水平高于对照组,差异均有统计学意义(P0.05)。观察组出现2例白细胞减少,1例肝功能异常患者,未出现严重不良反应。结论雷公藤多苷联合科素亚对老年IgA患者具有显著疗效,可明显降低患者尿蛋白,保护肾功能,且临床应用较安全,其可能通过降低TGF-β1、PAI-1及VEGF的表达而发挥作用。
[Abstract]:Objective to observe the clinical effect of tripterygium wilfordii polyglycoside combined with Kosu on the expression of transforming growth factor 尾 1 (TGF- 尾 1), plasminogen activator inhibitor 1 (PAI-1) and vascular endothelial growth factor (VEGF) in elderly patients with IgA nephropathy. Methods from April 2011 to January 2016, 80 elderly IgA patients treated in Jiaxing Hospital of Zhejiang Armed Police Force were randomly divided into control group and observation group with 40 cases each. Patients in both groups were treated with routine treatment of chronic underlying diseases and oral administration of Kosu, and the observation group took tripterygium wilfordii polyglycosides for 12 months. The levels of urinary protein, serum creatinine (Scr), urea nitrogen (Scr), plasma albumin (Alb), urinary TGF- 尾 1 (PAI-1) and VEGF were compared between the two groups before and after treatment for 6 and 12 months, and the incidence of adverse reactions was recorded. Results the levels of 24 hours urine protein in the observation group were lower than those in the control group at 3 and 12 months after the treatment (P0.05), and the levels of 24 hours urine protein in the observation group were lower than those in the control group at each time point (P0.05). After treatment, the levels of Scr,BUN and urinary TGF- 尾 1, PAI 1 and Alb in both groups were lower than those before treatment, and the levels of Scr,BUN and urine TGF- 尾 1 + PAI 1 were lower in the observation group than in the control group, and the levels of Alb were higher than those in the control group (P0.05). There were 2 cases of leukopenia and 1 case of abnormal liver function in the observation group. Conclusion Tripterygium wilfordii polyglycosides combined with Kos have a significant therapeutic effect on elderly patients with IgA, can significantly reduce urinary protein, protect renal function, and its clinical application is safe. It may play an important role by reducing the expression of TGF- 尾 1, PAI-1 and VEGF.
【作者单位】：武警浙江总队嘉兴医院肾内科;南昌大学医学院;
【分类号】：R692.31

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