摘要
目的:探讨雷公藤多苷片对肾脏移植术后服用西罗莫司出现蛋白尿的临床疗效及安全性。方法:接受西罗莫司治疗的肾移植病人214例中,68例病人肾脏移植术后服用西罗莫司出现蛋白尿(>1.5 g/24 h),随机分为对照组和观察组,各34例。对照组采用环磷酰胺1000 mg+0.9%氯化钠溶液250 mL静脉滴注,每月1次;观察组采用雷公藤多苷片治疗,40~60 mg/d;2组均持续治疗6个月。收集尿液标本,测定尿α1-微球蛋白(α1-MG)、β2-微球蛋白(β2-MG)、尿微量白蛋白(MAU)及24 h蛋白尿等,比较2组临床治疗效果及不良反应。结果:治疗后,2组病人各尿液指标均显著降低(P<0.01),且观察组尿α1-MG、β2-MG、24 h蛋白尿显著低于对照组(P<0.05)。与治疗前比较,2组治疗6个月后血肌酐、尿素氮、三酰甘油、丙氨酸氨基转移酶差异无统计学意义(P>0.05);治疗6个月后2组间比较血肌酐、尿素氮、三酰甘油、丙氨酸氨基转移酶差异无统计学意义(P>0.05)。2组间不良反应发生率差异无统计学意义(P>0.05)。结论:雷公藤多苷对肾脏移植术后服用西罗莫司出现蛋白尿的治疗效果确切,能改善肾移植受者预后。
Objective:To investigate the clinical effects and safety of tripterygium polyglycoside in the treatment of proteinuria in kidney transplantation patients taking sirolimus.Methods:Among 214 kidney transplantation patients treated with sirolimus,the proteinuria(>1.5 g/24 h)in 68 cases was found,and the patients were randomly divided into the control group and observation group(34 cases in each group).The control group was intravenously injected with 1000 mg of cyclophosphamide combined with 250 mL of 0.9%sodium chloride solution,once a month,and the observation group was treated with 40 to 60 mg/d of tripterygium polyglycoside.Two groups were treated for 6 months.The levels ofα1-microglobulin(α1-MG),β2-microglobulin(β2-MG),urinary albumin(MAU)and 24 h protein in urine in two groups were detected,and the clinical therapeutic effect and adverse reaction were compared between two groups.Results:After treatment,the urine indicators in two groups significantly decreased(P<0.01),and the levels ofα1-MG,β2-MG and 24 h urinary protein in observation group were significantly lower than those in control group(P<0.05).The differences of the serum levels of Scr,BUN,TG and ALT in two groups between before and after 6 months of tretament were not statistically significant(P>0.05).After 6 months of treatment,the differences of the serum levels of Scr,BUN,TG and ALT between two groups were not statistically significant(P>0.05).The difference of the incidence rate of adverse reaction between two groups was not statistically significant(P>0.05).Conclusions:Tripterygium polyglycoside in the treatment of proteinuria in kidney transplantation patients taking sirolimus has good effect,and can improve the prognosis of pateints.
作者
田园
刘映红
TIAN Yuan;LIU Ying-hong(Department of Nephrology,The Second Xiangya Hospital,Central South University,Changsha Hu′nan 410011;Department of Nephrology,The Second Affiliated Hospital of Hainan Medical University,Haikou Hainan 570311,China)
出处
《蚌埠医学院学报》
CAS
2020年第8期1060-1063,共4页
Journal of Bengbu Medical College
关键词
肾移植
雷公藤多苷
西罗莫司
蛋白尿
kidney transplantation
tripterygium polyglycoside
sirolimus
proteinuria
