肾病综合征患者经贝前列素钠联合醋酸泼尼松治疗后肾功能、凝血三项指标变化分析
赵晓凯 a ,高 杰 b
(新郑市中医院 a.内分泌肾内科;b.心血管内科,河南 新郑 451100)
摘要 目的:从肾功能、凝血三项指标等方面探究贝前列素钠联合醋酸泼尼松在肾病综合征(NS)治疗中的应用价值。 方法:选取 95 例 NS 患者,按照随机数字表法分为对照组(n = 47) 和实验组(n=48)。对照组采取醋酸泼尼松治疗,实验组在对照组基础上采取贝前列素钠治疗,连续治疗 3 个月,统计两组临床疗效、不良反应,比较治疗前后肾功能指标[血肌酐(Scr)、尿 β2-微球蛋白(β2-MG)、尿 N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、24 h 尿蛋白排泄率(24 h UPE)]、凝血三项指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)]。 结果:实验组治疗总有效率91.67%高于对照组 72.34%(P<0.05);治疗后,实验组 Scr、24 h UPE、尿 NAG、尿 β2-MG 水平低于对照组(P<0.05);治疗后,实验组 PT、TT、APTT 短于对照组(P<0.05);实验组不良反应总发生率10.42%与对照组 6.38%比较无统计学差异(P>0.05)。 结论:贝前列素钠联合醋酸泼尼松治疗 NS 效果显著,有助于改善凝血三项指标,恢复肾功能,且具有安全性。
关键词: 肾病综合征;贝前列素钠;醋酸泼尼松;肾功能;凝血三项指标
中图分类号:R692 文献标志码:A 文章编号:1008-2409(2022)03-0101-05
Changes of renal function and blood coagulation indexes in patients with nephrotic syndrome after beraprost sodium combined with prednisone acetate treatment
ZHAO Xiaokai a , GAO Jie b . ( a. Dept. of Endosecretory Nephrology; b. Dept. of Cardiology, Xinzheng Hospital of Traditional Chinese Medicine, Xinzheng 451100, China)
Abstract Objective: To investigate the application value of beraprost sodium combined with prednisone acetate in patients with nephrotic syndrome(NS)from the three indicators of blood coagulation and renal function. Methods: A prospective study of 95 NS patients was conducted. The patients were randomized into a control group(n = 47) and an experimental group(n = 48). The control group were treated with prednisone acetate, while the experimental group were treated with beraprost sodium on the basis of the control group for three months. Then, the clinical efficacy and adverse reactions were collected and compared between the two groups, and the renal function indexes[serum creatinine(Scr), urinary beta 2-microglobulin(β2-MG), urinary N-acetyl-β-D-glucosaminidase(NAG), 24 h urinary protein excretion rate(24 h UPE)], and blood coagulation indicators [ prothrombin time ( PT ), activated partial thromboplastin time(APTT)and thrombin time(TT)] were compared between the two groups before and after treatment. Results: The total effective rate of the experimental group was 91.67%, which was higher than that of the control group, 72.34%(P<0.05); after treatment, levels of SCR, 24 h UPE, urinary NAG and urinary β2-Mg in the experimental group were lower than those in the control group (P<0.05); PT, TT and APTT of the experimental group were shorter than those of the control group(P<0.05); and there was no statistical significance in the incidence of ADR between the experimental group(10.42%)and the control group(6.38%)(P>0.05). Conclusion: Beraprost sodium combined with prednisone acetate is effective in the treatment of patients with NS, which can improve the indexes of blood coagulation and restore renal function with certain safety.
Keywords: nephrotic syndrome; beraprost sodium; prednisone acetate; renal function; three indicators of blood coagulation
参考文献:
[1] WAREJKO J K,TAN W,DAGA A,et al.Whole exome sequencing of patients with steroid-resistant nephrotic syndrome[J].Clin J Am Soc Nephrol,2018,13(1):53-62.
[2] 付会玲.越婢加术汤合五苓散治疗成人原发性肾病综合征风水相搏证临床观察[J].四川中医,2020,38(2):125-128.
[3] 葛均波,徐永健.内科学[M].8 版.北京:人民卫生出版社,2013:477-485.
[4] WU J,GUO N,CHEN X,et al. Low triiodothyronine syndrome is associated with platelet function in patients withnephrotic syndrome[J].Rev Assoc Med Bras,2019,65(7):988-992.
[5] 马丹,高振宇.贝前列素钠联合环磷酰胺治疗肾病综合征病人的短、中期随访研究[J].蚌埠医学院学报,2020,45(3):355-359,362.
[6] 徐长青.肾病综合征患者血清 D-D 水平及凝血四项的检测与临床意义[J].中国医药指南,2020,18(16):174-175.
[7] 郭英,陈莹,崔瑶.尿 NAG 水平在老年非透析慢性肾脏病合并低蛋白血症病人中的临床意义[J].实用老年医学,2019,33(9):858-861.
[8] 褚静,陈玉娟,李晓云,等.原发性肾病综合征患儿血清可溶性尿激酶型纤溶酶原激活物受体和可溶性髓样细胞触发受体-1 表达变化的意义[J].中华实用儿科临床杂志,2018,33(5):358-362.
[9] 卞志翔,陈佩华,顾慧益,等.非布司他片联合贝前列素钠片对高尿酸血症合并慢性肾脏病患者疗效观察[J].重庆医学,2019,48(14):2484-2486,2489.
PDF下载:点击下载