论文部分内容阅读
目的观察尿激酶(UK)联合血管紧张素转换抑制剂(ACEI)治疗IgA肾病(IgAN)的疗效。方法75例Lee分级≥Ⅲ级的IgAN 随机分为两组:单用ACEI组(苯那普利10mg/d)及UK+ACEI组(苯那普利加UK治疗),对比两者的疗效。结果治疗3个月时UK+ACEI组与ACEI组显效率分别为48.65%、23.68%,P<0.05,总有效率分别为69.57%、39.47%,P<0.05,P<0.05。ACEI组尿NAG酶无显著变化、肌酐清除率(Ccr)显著下降,PT及纤维蛋白原(FIB)无显著变化,而UK+ACEI组尿NAG酶明显下降、Ccr无明显变化,PT延长、FIB水平明显降低,UK+ACEI治疗可使患者低下的血浆t-PA及尿PA活性得以恢复,随访结果表明它可使Scr稳定,80.95%(17/21)患者尿蛋白在1.0g/d 以下。37例中仅3例轻微出血。结论UK联合ACEI治疗中晚期病变IgAN疗效优于单用ACEI者,推测可能与UK提高患者的纤溶能力有关,为一种安全有效的方案。
Objective To observe the effect of urokinase (UK) combined with angiotensin converting inhibitor (ACEI) on IgA nephropathy (IgAN). Methods 75 cases of Lee with Grade Ⅲ or higher were randomly divided into two groups: ACEI group (benazepril 10mg / d) and UK + ACEI group (benazepril plus UK group). Results The effective rates of UK + ACEI group and ACEI group were 48.65% and 23.68% at 3 months after treatment, respectively. The total effective rates were 69.57% and 39.47%, respectively, P <0.05 and P <0.05. There was no significant change of urinary NAG in ACEI group, Ccr, FIB and FIB in UK + ACEI group, but no significant change in Ccr, prolong PT, FIB The levels of plasma AChE and ACEI decreased significantly in patients with low plasma t-PA and urinary PA. The follow-up results showed that Scr could stabilize Scr and lower than 1.0g / d in 80.95% (17/21) patients. Only three of 37 patients had mild bleeding. Conclusions The combination of UK and ACEI is superior to ACEI alone in the treatment of middle and advanced stage IgAN. It is presumed that UK combined with ACEI may be a safe and effective way to improve the fibrinolytic ability of patients.