地尔硫卓联合环孢素治疗肾病综合征伴急性肾损伤的临床观察

发布时间：2018-11-05 15:26

【摘要】：目的:观察地尔硫卓联合环孢素治疗肾病综合征伴急性肾损伤的疗效和安全性。方法:66例肾病综合征伴急性肾损伤患者随机分为对照组(30例)和观察组(36例)。对照组患者给予常规治疗;观察组患者在对照组治疗的基础上给予盐酸地尔硫卓片15 mg,口服,每日2次,环孢素软胶囊1.5 mg/(kg·d),口服,每日2次。两组疗程均为20 d。观察两组患者的临床疗效,治疗前后血肌酐、肾损伤分子1(KIM_(-1))、24 h尿蛋白量、24 h尿量、急性肾损伤分级,随访及复发情况,并记录不良反应发生情况。结果:观察组患者缓解率显著高于对照组,复发率显著低于对照组,差异均有统计学意义(P0.05)。治疗前,两组患者血肌酐、KIM_(-1)、24 h尿蛋白量、24 h尿量、急性肾损伤分级比较,差异均无统计学意义(P0.05)。观察组患者治疗2周、1个月后及对照组治疗1个月后血肌酐、KIM_(-1)、24 h尿蛋白量均显著低于同组治疗前,且观察组显著低于对照组同期;24 h尿量、急性肾损伤分级Ⅰ级例数均显著多于同组治疗前,且观察组显著高于对照组同期,差异均有统计学意义(P0.05)。两组患者随访率均为100%,不良反应发生率比较,差异无统计学意义(P0.05)。结论:在常规治疗的基础上,地尔硫卓联合环孢素治疗肾病综合征伴急性肾损伤的疗效显著,且安全性均较好。
[Abstract]:Objective: to observe the efficacy and safety of diltiazem combined with cyclosporine in the treatment of nephrotic syndrome with acute renal injury. Methods: 66 cases of nephrotic syndrome with acute renal injury were randomly divided into control group (30 cases) and observation group (36 cases). The patients in the control group were treated with routine therapy, and the patients in the observation group were treated with diltiazem hydrochloride tablets for 15 mg, and cyclosporine soft capsules for 1. 5 mg/ (kg d), twice a day. The course of treatment was 20 days in both groups. The clinical efficacy, serum creatinine, urine protein volume (KIM_ (-1), 24 h), 24 h urine volume, acute renal injury grade, follow-up and recurrence were observed before and after treatment, and adverse reactions were recorded. Results: the remission rate was significantly higher in the observation group than that in the control group, and the recurrence rate was significantly lower than that in the control group (P0.05). Before treatment, there was no significant difference in serum creatinine, KIM_ (-1), 24 h urine protein content, 24 h urine volume and acute renal injury grade between the two groups (P0.05). The levels of serum creatinine, KIM_ (-1), 24 h urine protein in the observation group were significantly lower than those in the same group after 2 weeks, 1 month and 1 month in the control group, and those in the observation group were significantly lower than those in the control group. 24 h urine volume, acute renal injury grade I cases were significantly higher than the same group before treatment, and the observation group was significantly higher than the control group in the same period, the difference was statistically significant (P0.05). The follow-up rate of the two groups was 100 and the incidence of adverse reactions was not statistically significant (P0.05). Conclusion: on the basis of routine therapy, diltiazem combined with cyclosporine is effective and safe in the treatment of nephrotic syndrome with acute renal injury.
【作者单位】：海南省中医院肾病风湿科;
【分类号】：R692

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