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目的评价雷公藤多苷与小剂量糖皮质激素治疗免疫球蛋白A肾病的临床疗效及其对患者T淋巴细胞亚群的影响。方法入选免疫球蛋白A肾病患者86例(试验组)和健康者91例(对照组)作为研究对象。试验组口服氯沙坦钾50 mg·d-1,qd+醋酸泼尼松片0.5 mg·kg-1,qd+雷公藤多苷片1 mg·kg-1,tid,疗程为3个月。分别检测患者治疗前后及健康查体人员血清T淋巴细胞Th1/Th2细胞因子及免疫球蛋白A的临床疗效。结果治疗前,试验组干扰素(IFN)-γ和白细胞介素(IL)-2显著低于对照组(P<0.05);IL-4和IL-10显著高于对照组(P<0.05)。治疗3个月后,试验组临床总有效率为91.8%。治疗后,试验组患者尿素氮、尿酸和血肌酸酐均较治疗前显著降低(P<0.05);IFN-γ及IL-2较治疗前显著升高(P<0.05),IL-4及IL-10较治疗前显著降低(P<0.05)。结论雷公藤多苷治疗免疫球蛋白A肾病的临床疗效确切,对患者T淋巴细胞亚群失衡有一定的调节作用。
Objective To evaluate the clinical efficacy of tripterygium glycosides and low dose glucocorticoid in treatment of immunoglobulin A nephropathy and its effect on T lymphocyte subsets. Methods Totally 86 patients (experimental group) and 91 healthy subjects (control group) were enrolled in the study. The trial group was given losartan potassium 50 mg · d-1, qd + prednisone acetate 0.5 mg · kg-1, qd + tripterygium wilfordii 1 mg · kg-1, tid for 3 months. The clinical efficacy of Th1 / Th2 cytokines and immunoglobulin A in serum T lymphocytes before and after treatment and before and after treatment were detected. Results Before treatment, the levels of IFN-γ and IL-2 in the experimental group were significantly lower than those in the control group (P <0.05); the levels of IL-4 and IL-10 in the experimental group were significantly higher than those in the control group . After 3 months of treatment, the total clinical effective rate in the experimental group was 91.8%. After treatment, the levels of blood urea nitrogen, uric acid and creatinine were significantly decreased (P <0.05); the levels of IFN-γ and IL-2 were significantly increased (P <0.05) -10 was significantly lower than before treatment (P <0.05). Conclusion Tripterygium glycosides treatment of immunoglobulin A nephropathy clinical curative effect on patients with imbalance of T lymphocyte subsets have a certain regulatory effect.