目的 研究骨化三醇聯(lián)合貝那普利治療膜性腎病的臨床效果。方法 選取2014年3月—2015年2月在石家莊市第一醫(yī)院腎內(nèi)科接受治療的膜性腎病患者80例,隨機(jī)分為對照組和治療組,每組各40例。對照組口服鹽酸貝那普利片,10 mg/次,1次/d,若療效不佳,可增加至20 mg。治療組在對照組治療基礎(chǔ)上口服骨化三醇膠丸,0.25 μg/次,1次/d。兩組均連續(xù)治療8周。觀察兩組的臨床療效,同時(shí)比較兩組治療前后血清白蛋白、24 h尿蛋白、血漿纖維蛋白原、收縮壓、舒張壓的變化情況。結(jié)果 治療后,對照組和治療組的總有效率分別為77.5%、90.0%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組24 h尿蛋白、血漿纖維蛋白原、收縮壓、舒張壓均顯著降低,血清白蛋白顯著升高,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P<0.05);治療后治療組這些觀察指標(biāo)的改善程度優(yōu)于對照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 骨化三醇聯(lián)合貝那普利治療膜性腎病具有較好的臨床療效,可降低患者的尿蛋白和血壓,提高血清白蛋白,具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To explore the clinical effect of calcitriol combined with benazepril in treatment of membranous nephropathy. Methods Patients (80 cases) with membranous nephropathy in Department of Nephrology of the First Hospital of Shijiazhuang from March 2014 to February 2014 were randomly divided into control and treatment groups, and each group had 40 cases. The patients in the control group were po administered with Benazepril Hydrochloride Tablets, 10 mg/time, once daily. If the clinic effect was unsatisfactory, the dosage could be increased to 20 mg. The patients in the treatment group were po administered with Calcitriol Soft Capsules on the basis of control group, 0.25 μg/time, once daily. The patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy were evaluated, and the changes of serum albumin, 24 h urine protein, blood plasma fibrinogen, systolic pressure, and diastolic blood pressure in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 77.5% and 90.0%, respectively, and there were differences between two groups (P < 0.05). After treatment, 24 h urine protein, blood plasma fibrinogen, systolic pressure, and diastolic blood pressure were significantly decreased, and serum albumin was significantly increased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Calcitriol combined with benazepril has clinical curative effect in treatment of membranous nephropathy, and can reduce the urine protein and blood pressure of patients, also can increase serum albumin, which has a certain clinical application value.

河北省醫(yī)學(xué)科學(xué)研究重點(diǎn)課題