依折麥布在膜性腎病中的臨床應用
發(fā)布時間：2019-06-08 09:57
【摘要】：目的：本試驗通過分別對試驗組與對照組患者進行臨床用藥、觀察并比較，兩種不同治療方案在膜性腎病合并血脂異�；颊哒{脂治療后的臨床療效、不良反應、及各項臨床檢測指標的變化差異，為膜性腎病合并血脂異�；颊咴谂R床調脂治療方面，提供新思想、新策略，更好地進行臨床調脂治療和預防血脂異常并發(fā)癥的發(fā)生。 方法：研究對象為2012年1月至2013年12月期間，在延安大學附屬醫(yī)院住院的患者共60例，診斷均符合原發(fā)性腎病綜合征，同時符合病理診斷均為膜性腎病，且治療前4周均未接受過調脂治療，肝功能及腎功能指標均正常。將研究對象隨機分為兩組：①試驗組（30例），給予口服辛伐他汀10mg，1次/日，聯(lián)合依折麥布10mg，1次/日；②對照組（30例），給予口服辛伐他汀20mg，1次/日。其余膜性腎病�？浦委熅嗤�。于服藥前、服藥2周末、4周末、8周末時，分別檢測患者血清各項血脂、轉氨酶、肌酸激酶、24小時尿蛋白定量指標水平，隨后觀察并記錄各組患者臨床用藥不良反應情況。采用SPSS16.0軟件包處理數(shù)據，組間比較用兩獨立樣本t檢驗，計數(shù)資料及兩樣本率比較用卡方檢驗。P 0.05有統(tǒng)計學差異。 結果：①服藥2周末、4周末時試驗組與對照組患者，各項血脂指標水平比較，無統(tǒng)計學差異，轉氨酶、肌酸激酶及24小時尿蛋白定量水平的變化比較，均無統(tǒng)計學差異(P0.05)。②服藥8周末，試驗組較對照組患者血清膽固醇水平有統(tǒng)計學差異（P0.05），余各項血脂指標及其他指標比較，，均無統(tǒng)計學差異(P0.05)。③服藥8周末，試驗組較對照組患者，不良反應發(fā)生率及調脂治療有效率，無統(tǒng)計學差異(P0.05)。 結論：①本試驗中依折麥布聯(lián)合辛伐他汀較單獨應用辛伐他汀在原發(fā)性膜性腎病患者的臨床調脂治療中可以減少膽固醇的吸收，進一步降低血漿中的膽固醇水平，更好地做到血脂達標，避免血脂異常引起的并發(fā)癥。②本試驗中聯(lián)合用藥組較單獨用藥組并未增加肝功能異常的風險率，在消化道等不良反應發(fā)生率上無統(tǒng)計學差異，同時兩組患者均無肌溶解等嚴重不良反應發(fā)生。
[Abstract]:Objective: to observe and compare the clinical efficacy and adverse reactions of the two different treatment schemes in patients with membranous nephropathy complicated with dyslipidemia after lipid regulation treatment, and to observe and compare the clinical efficacy and side effects of the two different treatments in patients with membranous nephropathy complicated with dyslipidemia. The changes of clinical detection indexes provided new ideas and strategies for patients with membranous nephropathy complicated with dyslipidemia in clinical lipid regulation treatment, so as to better carry out clinical lipid regulation treatment and prevent the occurrence of dyslipidemia complications. Methods: from January 2012 to December 2013, a total of 60 patients were hospitalized in the affiliated Hospital of Yan'an University. The diagnosis was in accordance with primary nephrotic syndrome and the pathological diagnosis was membranous nephropathy. No lipid regulating therapy was received 4 weeks before treatment, and the indexes of liver function and renal function were normal. The subjects were randomly divided into two groups: (1) the experimental group (n = 30) was given simvastatin 10 mg once a day, and the control group (30 cases) was given simvastatin 20 mg once a day. The other specialist treatments for membranous kidney disease were the same. Before taking medicine, at the end of 2nd, 4th and 8th week, the levels of serum lipid, transaminase, creatine kinase and 24-hour urinary protein were measured, and then the adverse reactions of clinical medication were observed and recorded. SPSS16.0 software package was used to process the data, two independent samples t test, counting data and chi-square test were used to compare the two sample rates. There was significant difference between the two groups. Results: 1 at the end of 2 weeks and 4 weeks, there was no significant difference in the levels of blood lipids between the experimental group and the control group, and the quantitative levels of transaminase, creatine kinase and 24-hour urinary protein were compared. There was no significant difference (P 0.05). 2 at the end of 8 weeks, the serum cholesterol level of the experimental group was significantly different from that of the control group (P 0.05), and the rest of the blood lipid indexes and other indexes were compared. There was no significant difference (P 0.05). 3 at the end of 8 weeks, the incidence of adverse reactions and the effective rate of lipid regulation in the experimental group were not significantly different from those in the control group (P 0.05). Conclusion: 1 in this study, etumab combined with simvastatin alone can reduce the absorption of cholesterol and further reduce the level of cholesterol in patients with primary membranous kidney disease in the clinical treatment of lipid regulation in patients with primary membranous kidney disease (PNS). The results show that simastatin alone can reduce the absorption of cholesterol and further decrease the level of cholesterol in plasma of patients with primary membranous nephropathy. In this experiment, the combined drug group did not increase the risk rate of abnormal liver function, and there was no significant difference in the incidence of adverse reactions such as digestive tract. At the same time, there were no serious adverse reactions such as myolysis in both groups.
【學位授予單位】：延安大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R692
本文編號：2495200
[Abstract]:Objective: to observe and compare the clinical efficacy and adverse reactions of the two different treatment schemes in patients with membranous nephropathy complicated with dyslipidemia after lipid regulation treatment, and to observe and compare the clinical efficacy and side effects of the two different treatments in patients with membranous nephropathy complicated with dyslipidemia. The changes of clinical detection indexes provided new ideas and strategies for patients with membranous nephropathy complicated with dyslipidemia in clinical lipid regulation treatment, so as to better carry out clinical lipid regulation treatment and prevent the occurrence of dyslipidemia complications. Methods: from January 2012 to December 2013, a total of 60 patients were hospitalized in the affiliated Hospital of Yan'an University. The diagnosis was in accordance with primary nephrotic syndrome and the pathological diagnosis was membranous nephropathy. No lipid regulating therapy was received 4 weeks before treatment, and the indexes of liver function and renal function were normal. The subjects were randomly divided into two groups: (1) the experimental group (n = 30) was given simvastatin 10 mg once a day, and the control group (30 cases) was given simvastatin 20 mg once a day. The other specialist treatments for membranous kidney disease were the same. Before taking medicine, at the end of 2nd, 4th and 8th week, the levels of serum lipid, transaminase, creatine kinase and 24-hour urinary protein were measured, and then the adverse reactions of clinical medication were observed and recorded. SPSS16.0 software package was used to process the data, two independent samples t test, counting data and chi-square test were used to compare the two sample rates. There was significant difference between the two groups. Results: 1 at the end of 2 weeks and 4 weeks, there was no significant difference in the levels of blood lipids between the experimental group and the control group, and the quantitative levels of transaminase, creatine kinase and 24-hour urinary protein were compared. There was no significant difference (P 0.05). 2 at the end of 8 weeks, the serum cholesterol level of the experimental group was significantly different from that of the control group (P 0.05), and the rest of the blood lipid indexes and other indexes were compared. There was no significant difference (P 0.05). 3 at the end of 8 weeks, the incidence of adverse reactions and the effective rate of lipid regulation in the experimental group were not significantly different from those in the control group (P 0.05). Conclusion: 1 in this study, etumab combined with simvastatin alone can reduce the absorption of cholesterol and further reduce the level of cholesterol in patients with primary membranous kidney disease in the clinical treatment of lipid regulation in patients with primary membranous kidney disease (PNS). The results show that simastatin alone can reduce the absorption of cholesterol and further decrease the level of cholesterol in plasma of patients with primary membranous nephropathy. In this experiment, the combined drug group did not increase the risk rate of abnormal liver function, and there was no significant difference in the incidence of adverse reactions such as digestive tract. At the same time, there were no serious adverse reactions such as myolysis in both groups.
【學位授予單位】：延安大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R692
【參考文獻】
相關期刊論文 前7條
1 衣淑華;衣淑珍;;降血脂藥物臨床合理用藥研究進展[J];國際藥學研究雜志;2012年03期
2 李海龍,唐福林,李軍;類風濕關節(jié)炎外周血PBMC中MIP-1α和RANTES的表達[J];醫(yī)學臨床研究;2004年02期
3 高緒霞;他汀類藥物治療腎臟疾病研究進展[J];中國動脈硬化雜志;2003年S1期
4 許梅花;方今女;;血脂異常的危險因素研究進展[J];延邊大學醫(yī)學學報;2010年03期
5 劉梅林;;常用調脂藥物的分類、用途及主要副作用(續(xù)3)[J];中國循環(huán)雜志;2010年01期
6 寇文昒;;血脂異常的非藥物治療(續(xù)4)[J];中國循環(huán)雜志;2010年02期
7 陶建瓴,李學旺,蘇穎,段琳,林嘉友;低密度脂蛋白及氧化修飾低密度脂蛋白對人系膜細胞增殖及基質合成的影響[J];中華腎臟病雜志;2000年05期
本文編號：2495200
本文鏈接：http://sikaile.net/yixuelunwen/mjlw/2495200.html
最近更新
教材專著
