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目的探讨厄贝沙坦治疗Ig A肾病的临床疗效及安全性。方法选取2012年4月—2014年4月收治的Ig A肾病患者60例作为研究对象,随机分为对照组和试验组各30例。对照组患者给予口服双嘧达莫治疗,150 mg/次,1次/d;试验组在对照组的基础上加用厄贝沙坦治疗,200 mg/次,1次/d;1个月为1个疗程,两组均治疗3个疗程。比较两组临床疗效及SBP、DBP、Scr、BUN、24 h尿蛋白定量变化情况。计量资料组间比较采用t检验,组内比较采用配对t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果试验组临床缓解率为70.0%,明显高于对照组的40.0%,差异有统计学意义(P<0.05)。治疗后,试验组患者的SBP、DBP、Scr、BUN、24 h尿蛋白定量分别为(126.73±4.08)、(85.24±3.76)mm Hg(1 mm Hg=0.133 k Pa)、(84.36±8.98)、(6.01±1.03)mmol/L、(1.13±0.37)g/24 h,均明显低于治疗前的(146.48±6.03)、(98.53±4.26)mm Hg、(119.22±13.41)、(8.69±1.15)mmol/L、(2.75±0.48)g/24 h,差异均有统计学意义(均P<0.05)。治疗后试验组SBP、DBP、Scr、BUN以及24 h尿蛋白定量与对照组[(142.11±5.76)、(95.02±4.21)mm Hg、(110.10±13.71)、(8.20±1.33)mmol/L、(2.38±0.53)g/24 h]比较差异均有统计学意义(均P<0.05)。结论厄贝沙坦可以有效缓解Ig A肾病患者的各项临床指标,且没有明显的不良反应,值得临床推广使用。
Objective To investigate the clinical efficacy and safety of irbesartan in the treatment of IgA nephropathy. Methods Sixty patients with IgA nephropathy who were admitted from April 2012 to April 2014 were selected as study subjects and randomly divided into control group and test group of 30 cases each. Patients in the control group were treated with dipyridamole orally at a dosage of 150 mg once daily for 1 month on the basis of the control group. Irbesartan was also used in the test group at 200 mg once daily for 1 month For a course of treatment, both groups were treated 3 courses. The clinical curative effect and the quantitative changes of urinary protein of SBP, DBP, Scr, BUN and 24 h were compared between the two groups. Measurement data were compared between groups using t test, the group was compared using paired t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The clinical remission rate of the experimental group was 70.0%, which was significantly higher than that of the control group (40.0%), the difference was statistically significant (P <0.05). After treatment, the urinary proteins of SBP, DBP, Scr, BUN and 24 h were (126.73 ± 4.08), (85.24 ± 3.76) mm Hg (1 mm Hg = 0.133 kPa) and (84.36 ± 8.98) (6.01 ± 1.03) mmol / L and (1.13 ± 0.37) g / 24 h respectively, which were significantly lower than those before treatment (146.48 ± 6.03, 98.53 ± 4.26 mmHg, (119.22 ± 13.41) and (8.69 ± 1.15) mmol / L and (2.75 ± 0.48) g / 24 h, respectively (all P <0.05). After treatment, SBP, DBP, Scr, BUN and 24 h urinary protein in the test group were significantly higher than those in the control group [(142.11 ± 5.76), (95.02 ± 4.21) mm Hg, (110.10 ± 13.71) and (8.20 ± 1.33) mmol / (2.38 ± 0.53) g / 24 h] (all P <0.05). Conclusion Irbesartan can effectively relieve IgA nephropathy in patients with various clinical indicators, and no obvious adverse reactions, it is worth promoting the use of the clinic.