Abstract：Objective: To analyze the efficacy of cyclophosphamide combined with low-dose hormone in the treatment of membranous nephropathy and the level of serum phospholipase A2 receptor (PLA2R), 25-dihydroxyvitamin D3 (25 (OH)D3), neutrophil gelatinase-associated lipocalin (NGAL) changes. Methods: Eighty-seven patients with membranous nephropathy admitted to our hospital from April 2015 to March 2018 were enrolled, they were divided into the observation group (42 cases) and the control group (45 cases) according to simple random grouping method. The control group was treated with cyclophosphamide, and the observation group was treated with small doses of hormone on the basis of control group. The clinical efficacy, 24h urine protein quantitation, serum total cholesterol, serum creatinine, serum albumin, serum PLA2R, 25(OH)D3, NGAL levels of the two groups was compared. Results: After treatment, the total clinical effective rate of the observation group was significantly higher than that of the control group (P<0.05). Before treatment, there was no significant difference in 24h urine protein quantitation, serum total cholesterol, serum creatinine and serum albumin between the two groups (P>0.05). After 1 month, 3 months and 6 months of treatment, the two groups of patients with 24h urine protein quantification showed a decreasing trend (P<0.05), but the observation group were always lower than the control group (P<0.05), serum albumin showed a increasing trend (P<0.05), and the observation group were always higher than the control group (P<0.05). There were significant differences in 24h urine protein quantitation and serum albumin between groups, at different time points, between groups, and at different time points (P<0.05). After the 1 month, 3 months, 6 months treatment, serum total cholesterol and serum creatinine showed a downward trend (P<0.05), but there was no significant difference between the two groups (P>0.05). Before treatment, there was no significant difference in serum levels of PLA2R, 25(OH)D3 and NGAL between the two groups (P>0.05). After 1 month, 3 months and 6 months of treatment, the levels of serum PLA2R and NGAL decreased. (P<0.05), the observation group was always lower than the control group (P<0.05), the serum 25(OH)D3 level of the two groups showed an increasing trend (P<0.05), and the observation group was always higher than the control group (P<0.05). There were significant differences in the interaction between the two groups at different time points, between groups, and at different time points (P<0.05). There was no significant difference in the adverse reaction rate between the observation group and the control group (P>0.05). Conclusion: Cyclophosphamide combined with low-dose hormones can effectively reduce the level of PLA2R and NGAL, increase the level of serum 25 (OH) D3 and improve the clinical symptoms of patients with membranous nephropathy. The clinical efficacy is good and the safety is high.
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2019, Vol. 25 
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