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
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篇名: 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
TITLE:
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(P<0.05)。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(P>0.05)。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(P<0.05)。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(P>0.05)。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 therapeutic efficacies and safety of diltiazem combined with ciclosporine in the treatment of nephrotic syndrome complicated with acute renal injury. METHODS: A total of 66 patients with nephrotic syndrome and cute kidney injury were randomly divided into control group (30 cases) and observation group (36 cases). Control group was given routine treatment; observation group was additionally given Diltiazem hydrochloride tablet 5 mg orally, twice a day, and Ciclosporin soft capsules 1.5 mg/(kg·d) orally, twice a day. Treatment course of 2 groups lasted for 20 d. Clinical efficacies of 2 groups were observed. The serum creatinine and kidney injury molecule 1 (KIM-1), 24 h urine volume, 24 h urine protein levels, AKI classification, follow-up and recurrence were observed before and after treatment as well as the occurrence of ADR. RESULTS: The remission rate of observation group was significantly higher than that of control group, and recurrence rate was significantly lower than control group, with statistical significance (P<0.05). Before treatment,there was no statistical significance in the serum creatinine levels,KIM-1,24 h urine pratein, 24 h urine and AKI classification between 2 groups (P>0.05). After 2 weeks and 1 month of treatment of observatiom groups, and after 1 month of treatment of control group, serum creatinine levels, KIM-1 and 24 h urine protein of observation group were significantly lower than before treatment, and the observation group was significantly lower than the control group; 24 h urine and the ratio of gradeⅠby AKI classification were significantly more than before treatment, and the observation group was significantly more than the control group, with statistical significance (P<0.05). Follow-up rate in 2 groups were 100%,and there was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS: Based on routine treatment, diltiazem combined with ciclosporin shows significant therapeutic efficacy in the treatment of nephrotic syndrome and acute renal injury with good safety.
期刊: 2017年第28卷第18期
作者: 李艳娟,段小军
AUTHORS: LI Yanjuan,DUAN Xiaojun
关键字: 地尔硫卓;环孢素;肾病综合征;急性肾损伤;疗效;安全性
KEYWORDS: Diltiazem; Ciclosporin; Nephrotic syndrome; Acute renal injury; Therapeutic efficacy; Safety
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