Effect of angiotensin converting enzyme inhibitors or angiotensin Ⅱ receptor blockers combined with glucocorticoid in the treatment of IgA nephropathy
10.7683/xxyxyxb.2024.06.015
- VernacularTitle:血管紧张素转化酶抑制剂或血管紧张素Ⅱ受体阻滞剂联合糖皮质激素治疗IgA肾病疗效观察
- Author:
Xiaoli SUN
1
;
Weili XIN
;
Yongbing GUO
Author Information
1. 安阳地区医院肾病风湿科,河南 安阳 455000
- Keywords:
angiotensin converting enzyme inhibitor;
angiotensin Ⅱ receptor blockers;
glucocorticoid;
IgA nephropathy
- From:
Journal of Xinxiang Medical College
2024;41(6):581-584
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical efficacy of angiotensin converting enzyme inhibitors(ACEI)or angiotensin Ⅱ receptor blockers(ARB)combined with glucocorticoid in treating IgA nephropathy patients.Methods A total of 125 IgA nephropathy patients admitted to Anyang District Hospital from October 2019 to October 2022 were selected as the research subjects.The patients were randomly divided into the control group(n=62)and the observation group(n=63).Patients in the control group were given ACEI or ARB treatment,while patients in the observation group were given ACEI or ARB combined with fluticasone propionate inhalation aerosol.All patients were treated continuously for 3 months.The treatment effect was compared between the two groups.The 24-hour urinary protein quantitation,serum creatinine(Scr),glomerular filtration rate(GFR),white blood cell(WBC)count,hemoglobin(HGB)level,and platelet(PLT)count of patients in the two groups were measured before and after treatment.The occurrence of adverse reactions during treatment in the two groups was recorded.Results The overall effective rates of patients in the control group and the observation group were 54.84％(34/62)and 84.13％(53/63),respectively;the overall effective rate of patients in the observation group was significantly higher than that in the control group(x2=12.669,P＜0.05).Before treatment,there was no significant difference in 24-hour urinary protein quantitation,Scr and GFR between the two groups(P＞0.05).There was no significant difference in 24-hour urinary protein quantitation of patients before and after treatment in the control group(P＞0.05),and the 24-hour urinary protein quantitation of patients after treatment in the observation group was significantly lower than that before treatment(P＜0.05).After treatment,Scr in the two groups was significantly lower than that before treatment,and GFR was significantly higher than that before treatment(P＜0.05).After treatment,24-hour urinary protein quantitation in the observation group was significantly lower than that in the control group(P＜0.05);and there was no significant difference in Scr and GFR between the two groups(P＞0.05).There was no significant difference in WBC,HGB and PLT of patients before and after treatment in the two groups(P＞0.05).No adverse reactions,such as abnormal glucose tolerance,steroid diabetes and elevated blood pressure,occurred in the two groups during treatment.Conclusion Fluticasone propionate inhalation aerosol combined with ACEI or ARB can re-duce the 24-hour urinary protein quantitation and improve the renal function of IgA nephropathy patients,without the risk of causing blood system damage.It is a safe approach with significant efficacy.
