目的 研究骨化三醇联合贝那普利治疗膜性肾病的临床效果。方法 选取2014年3月—2015年2月在石家庄市第一医院肾内科接受治疗的膜性肾病患者80例,随机分为对照组和治疗组,每组各40例。对照组口服盐酸贝那普利片,10 mg/次,1次/d,若疗效不佳,可增加至20 mg。治疗组在对照组治疗基础上口服骨化三醇胶丸,0.25 μg/次,1次/d。两组均连续治疗8周。观察两组的临床疗效,同时比较两组治疗前后血清白蛋白、24 h尿蛋白、血浆纤维蛋白原、收缩压、舒张压的变化情况。结果 治疗后,对照组和治疗组的总有效率分别为77.5%、90.0%,两组比较差异有统计学意义(P<0.05)。治疗后,两组24 h尿蛋白、血浆纤维蛋白原、收缩压、舒张压均显著降低,血清白蛋白显著升高,同组治疗前后差异有统计学意义(P<0.05);治疗后治疗组这些观察指标的改善程度优于对照组,两组比较差异具有统计学意义(P<0.05)。结论 骨化三醇联合贝那普利治疗膜性肾病具有较好的临床疗效,可降低患者的尿蛋白和血压,提高血清白蛋白,具有一定的临床推广应用价值。

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.

河北省医学科学研究重点课题