目的 探討雷公藤多苷聯(lián)合貝那普利對(duì)老年原發(fā)性膜性腎小球腎炎患者的臨床治療效果以及治療后患者機(jī)體內(nèi)炎癥各項(xiàng)指標(biāo)水平的變化情況。方法 收集商洛市中心醫(yī)院自2015年1月-2017年1月間收治的老年原發(fā)性膜性腎小球腎炎患者91例作為研究對(duì)象，按照隨機(jī)數(shù)字表法分為研究組47例和對(duì)照組44例，對(duì)照組患者使用貝那普利進(jìn)行治療，同時(shí)給予對(duì)癥治療，研究組患者在此基礎(chǔ)上使用雷公藤多苷進(jìn)行治療，觀察兩組患者的臨床效果以及腫瘤壞死因子-α（TNF-α）、超敏C反應(yīng)蛋白（hs-CRP）以及白介素-6（IL-6）等炎癥指標(biāo)水平的變化情況。結(jié)果 研究組患者臨床總有效率93.62%，明顯高于對(duì)照組77.27%，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療前兩組患者24 h尿蛋白、尿素氮、腎小球?yàn)V過(guò)率各項(xiàng)指標(biāo)比較差異不顯著；治療后以上各指標(biāo)水平均發(fā)生明顯改善，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；其中研究組改善效果明顯優(yōu)于對(duì)照組，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組患者治療前TNF-α、hs-CRP和IL-6等各項(xiàng)炎癥因子水平比較差異不大；治療后兩組以上指標(biāo)均明顯下降，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；其中研究組患者各項(xiàng)水平顯著低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 雷公藤多苷聯(lián)合貝那普利能夠抑制老年原發(fā)性膜性腎小球腎炎患者體內(nèi)炎癥因子的表達(dá)，改善腎功能和臨床癥狀，效果顯著，可推廣使用。

Objective To investigate the clinical therapeutic and efficacy of Tripterygium tilfordii Glycosides for elderly patients with Idiopathic Membranous Glomerulonephritis. And analyze the various indicators of inflammation on patients after the treatment.Methods From January 2010 to January 2017 91 patients with idiopathic membranous glomerulonephritis in our hospital were collected as the research object, and randomly divided into the study group 47 cases and control group 44 cases. Control group were performed the Benner Pury treatment and symptomatic treatment. Based on treatment of Control group, the patients in the study group were given Tripterygium wilfordii glycosides treatment. The clinical effect, tumor necrosis factor α (TNF-α), high sensitive C reactive protein (hs-CRP), interleukin -6 (IL-6) and changes of inflammatory factors were observed in two groups.Results The study group patients clinical total effective rate was 93.62% and significantly higher than the control group (77.27%) (P< 0. 05). there was no significant difference between study group and control group on 24h urine protein, urea nitrogen and glomerular filtration rate before treatment. And the level of each index were significantly improved after treatment, while the study group was obviously better than control group, the difference was statistically significant (P< 0.05). Before treatment two groups of patients has no significant difierence on TNF-α, hs-CRP and IL-6. The level of TNF-α, hs-CRP and IL-6 in two groups were decreased after treatment, and the study group was significantly lower than the control group (P< 0.05).Conclusion Tripterygium glycosides can inhibit the expression of inflammatory factors in elderly patients with Idiopathic Membranous Glomerulonephritis, and improve renal function and clinical symptoms. The clinical therapeutic and efficacy of Tripterygium glycosides is significant, worthy to recommand its clinical use.