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目的:在特发性膜性肾病(IMN)常规治疗基础上上增加瑞舒伐他汀钙治疗,检测不同时间患者的生化指标,探讨瑞舒伐他汀钙降脂治疗中的效果。方法:选择115例已达肾病综合征诊断标准的原发性膜性肾病的病人。对照组55例予以醋酸泼尼松龙(GC)、环磷酰胺(CTX)、双嘧达莫、钙尔奇D、α-骨化醇及对症支持治疗,治疗组在对照组基础上加以瑞舒伐他汀钙10 mg每晚。观察疗程12周,分别记录治疗前、治疗4周末、8周末、12周末时患者生化指标及不良反应发生情况。结果:1.同一时间点两组间比较显示:总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、脂蛋白a(LP(a))、纤维蛋白原(FIB)在治疗4周末两组之间差异已有统计学意义(P<0.05),胱抑素C(CsyC)、载脂蛋白B(APOB)、白蛋白(ALB)、24小时尿蛋白定量(UTP)在治疗8周末两组之间差异已有统计学意义(P<0.05),高密度脂蛋白(HDL)在治疗12周末两组之间差异有统计学意义(P<0.05)。2.治疗前后组内比较显示:治疗组血肌酐(Scr)、TC、LP(a)、HDL、LDL、APOB、UTP、ALB、FIB在治疗4周末与治疗前相比差异已有统计学意义(P<0.05),CsyC、TG在治疗8周末与治疗前相比差异有统计学意义(P<0.05);对照组Scr、UTP、ALB、HDL、FIB在治疗4周末与治疗前相比差异已有统计学意义(P<0.05),LDL、LP(a)在治疗8周末与治疗前相比差异已有统计学意义(P<0.05),TC、TG、APOB在治疗12周末与治疗前相比差异有统计学意义(P<0.05)。3.治疗组转氨酶升高、横纹肌溶解、血栓栓塞等不良反应发生率低于对照组。结论:瑞舒伐他汀钙在特发性膜性肾病治疗中有比较显著的降脂作用,临床疗效显著且不良反应发生率低。
OBJECTIVE: To increase the dose of rosuvastatin calcium on the basis of conventional treatment of idiopathic membranous nephropathy (IMN), to detect the biochemical indexes of patients at different time and to investigate the effect of rosuvastatin on lipid-lowering therapy. Methods: A total of 115 patients with primary membranous nephropathy who had been diagnosed with nephrotic syndrome were enrolled. The control group of 55 patients were given prednisolone acetate (GC), cyclophosphamide (CTX), dipyridamole, Calcium D, α-calciferol and symptomatic and supportive treatment, the treatment group on the basis of the control group to Switzerland Shuvastatin Calcium 10 mg per night. The course of treatment was observed for 12 weeks. The biochemical indexes and adverse reactions of patients before treatment, 4 weeks after treatment, 8 weeks after surgery and 12 weeks after surgery were recorded. The levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), lipoprotein a (LP), fibrinogen (FIB) There was significant difference between the two groups at the end of the 4th week of treatment (P <0.05), CsyC, APOB, ALB, UTP, There was a significant difference between the two groups at the end of the 8th week of treatment (P <0.05). The difference of HDL between the two groups at the end of the 12th week was statistically significant (P <0.05). Compared before and after the treatment, the differences of the levels of serum creatinine (Scr), TC, LP (a), HDL, LDL, APOB, UTP, ALB and FIB in the treatment group were statistically significant (P <0.05). The levels of CsyC, TG in the 8th weekend after treatment were significantly different from those before treatment (P <0.05). The levels of Scr, UTP, ALB, HDL and FIB in the control group at the end of 4 weeks were different from those before treatment (P <0.05). The differences of LDL and LP (a) between the two groups at the end of the 8th week of treatment were statistically significant (P <0.05) Compared with the difference was statistically significant (P <0.05). The treatment group, aminotransferase, rhabdomyolysis, thromboembolism and other adverse reactions was lower than the control group. Conclusion: Rosuvastatin calcium has a significant lipid-lowering effect in the treatment of idiopathic membranous nephropathy, with a significant clinical effect and a low incidence of adverse reactions.