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中国当代医药  2022, Vol. 29 Issue (10): 10-13转19    
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环磷酰胺联合来氟米特对狼疮性肾炎患者24h尿蛋白及血清β2微球蛋白水平的影响
关毅标 罗福漳 李艳华
广东省佛山市南海区人民医院肾脏风湿免疫科,广东佛山 528200
Effect of Cyclophosphamide combined with Leflunomide on 24 h urine protein and serum β2 microglobulin levels in patients with lupus nephritis
GUAN Yibiao   LUO Fuzhang   LI Yanhua
Department of Nephrorheumatology,Nanhai People's Hospital in Foshan City,Guangdong Province,Foshan 528200,China
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摘要 目的 探讨环磷酰胺联合来氟米特对狼疮性肾炎患者24h尿蛋白及血清β2微球蛋白水平的影响。方法 选取2018年8月至2020年8月佛山市南海区人民医院收治的68 例狼疮性肾炎患者作为研究对象,采用随机信封分组法将其分为单一组(n=34)和联合组(n=34)。单一组患者采取静脉滴注环磷酰胺治疗,联合组患者在静脉滴注环磷酰胺基础上,口服来氟米特治疗。比较两组患者治疗前后的24h尿蛋白定量及血清β2微球蛋白水平;比较两组治疗前后的肝肾功能各项指标变化情况;分析两组患者的临床治疗总有效率及不良反应发生率差异。结果 治疗前,两组患者的24h尿蛋白定量及血清β2微球蛋白水平比较,差异无统计学意义(P>0.05);治疗后,联合组患者的24h尿蛋白定量及血清β2微球蛋白水平均低于单一组,差异有统计学意义(P<0.05)。治疗前,两组患者的血清尿素氮、血清肌酐、天冬氨酸转氨酶及丙氨酸转氨酶水平比较,差异无统计学意义(P>0.05);治疗后,联合组的血清尿素氮、血清肌酐、天冬氨酸转氨酶及丙氨酸转氨酶水平低于单一组,差异均有统计学意义(P<0.05)。联合组患者的治疗总有效率高于单一组,差异有统计学意义(P<0.05)。联合组患者的不良反应总发生率低于单一组,差异有统计学意义(P<0.05)。结论 对狼疮性肾炎患者采取环磷酰胺与来氟米特联合治疗,可有效改善24h尿蛋白及血清β2微球蛋白水平,同时还能改善患者的肝肾功能各项指标,有助于临床治疗总有效率的提升,且产生不良反应较少,安全性较高,有一定的临床推广和应用价值。
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关毅标
罗福漳
李艳华
关键词 血清&beta2微球蛋白24h尿蛋白狼疮性肾炎环磷酰胺来氟米特治疗有效率    
Abstract:Objective To investigate the effect of Cyclophosphamide combined with Leflunomide on 24 h urine protein and serum β2 microglobulin levels in patients with lupus nephritis.Methods A total of 68 patients with lupus nephritis who were admitted to Nanhai District People's Hospital in Foshan City from August 2018 to August 2020 were selected as the research objects,and they were divided into single group(n=34)and combined group(n=34)by random envelope grouping method.The single group was treated with intravenous Cyclophosphamide,and the combined group was treated with Leflunomide orally on the basis of intravenous Cyclophosphamide.The 24 h urine protein and serum β2 microglobulin levels were compared between the two groups before and after treatment.The changes of liver and kidney function indexes were compared between the two groups before and after treatment.The differences of total effective rate and incidence of adverse reactions between the two groups were analyzed.Results Before treatment,there were no significant differences in the 24 h urine protein level and serum β2 microglobulin level between the two groups(P>0.05).After treatment,the 24 h urinary protein level and serum β2 microglobulin level in combined group were lower than those in single group,the differences were statistically significant(P<0.05).Before treatment,there were no statistical significances in serum urea nitrogen,serum creatinine,aspartate aminotransferase and alanine aminotransferase levels between the two groups(P>0.05).After treatment,the levels of serum urea nitrogen,serum creatinine,aspartate aminotransferase and alanine aminotransferase in combined group were lower than those in single group,the differences were statistically significant(P<0.05).The total effective rate of combined group was higher than that of single group,and the difference was statistically significant(P<0.05).The total incidence of adverse reactions in combined group was lower than that in single group,and the difference was statistically significant(P<0.05).Conclusion The combined treatment of Cyclophosphamide and Leflunomide in patients with lupus nephritis can effectively improve 24 h urine protein and serum β2 microglobulin levels,and at the same time improve various indexes of liver and kidney function,which contributes to the overall effective rate of clinical treatment promote.In addition,the adverse reactions are small,the safety is high,and it has certain clinical promotion and application value.
Key wordsSerum &beta       microglobulin    24 h urine protein    Lupus nephritis    Cyclophosphamide    Leflunomide    Treatment efficiency
    
基金资助:广东省佛山市自筹经费类科技计划项目(2015A B000262
作者简介: 关毅标(1979-),男,汉族,广东佛山人,副主任医师,研究方向:慢性原发或继发性肾脏病、腹膜透析、血液透析
引用本文:   
关毅标;罗福漳;李艳华. 环磷酰胺联合来氟米特对狼疮性肾炎患者24h尿蛋白及血清β2微球蛋白水平的影响[J]. 中国当代医药, 2022, 29(10): 10-13转19.
GUAN Yibiao; LUO Fuzhang; LI Yanhua. Effect of Cyclophosphamide combined with Leflunomide on 24 h urine protein and serum β2 microglobulin levels in patients with lupus nephritis. 中国当代医药, 2022, 29(10): 10-13转19.
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