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| Clinical Efficacy of Leflunomide Combined with Moderate Dose Prednisone in Treatment of IgA Nephropathy and Effects on Serum Levels of ICAM-1 MCP-1 and TGF-β1 |
| ZHAO Jing'an, JI Yan |
| Jingzhou Second People's Hospital, Hubei Jingzhou 434000, China |
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Abstract Objective: To investigate the effect of leflunomide combined with moderate doses of prednisone in the treatment of IgA nephropathy (Immunoglobulin A nephropathy) the clinical effect of serum intercellular adhesion molecule -1 (ICAM-1 intercellular adhesion molecule-1), monocyte chemoattractant protein -1 (monocyte chemotactic protein 1, MCP-1), transformation growth factor beta 1 (transforming growth factor beta TGF- 1, β1). Methods: 96 patients with IgA nephropathy admitted to our hospital from October 2013 to May 2016 were randomly divided into control group and experimental group, with 48 cases in each group. All patients on admission were treated with conventional treatment. On the basis of this treatment, the control group received a large dose of prednisone, and the experimental group received leflunomide and a medium dose of prednisone.The clinical efficacy of the two groups before and after treatment was observed and compared. The levels of serum ICAM-1, MCP-1, TGF-β1, adverse reactions were observed in the two groups. Results: After treatment, the effective rate of the experimental group (95.83%) was higher than that of the control group (81.25%), and the difference was statistically significant (P<0.05). 3 months and 6 months after treatment, the levels of serum ICAM-1, MCP-1 and TGF-β1 were significantly decreased in the two groups, and the experimental group was significantly lower than that of the control group. There was a significant difference in the interaction between the two groups, different points and between groups and at the same time (P<0.05). There was no significant difference in adverse reactions between the two groups (P>0.05). Conclusion: The effect of leflunomide and moderate dosage of prednisone in the treatment of IgA nephropathy is sure to reduce the level of serum ICAM-1, MCP-1 and TGF-β1, which is worthy of clinical application.
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[1] 张亚昱,高进.MCP-1与IgA肾病[J].内蒙古医学杂志,2009,41(2):198-200.
[2] 王霄一,朱鸣,丁敏,等.原发性IgA肾病肾组织及血中转化生长因子-β1表达的相关性[J].中国中西医结合肾病杂志,2009,10(7):619~620.
[3] 吴升芹,王建生.来氟米特联合糖皮质激素治疗IgA肾病疗效观察[J].中华实用诊断与治疗杂志,2014,28(5):504~506.
[4] 高进,张谦,张铎.IgA肾病单核细胞趋化蛋白-1含量的动态变化及临床意义[J].中国中西医结合肾病杂志,2014,15(9):780~783.
[5] 聂莉芳,于大君,余仁欢,等.IgA肾病综合临床疗效评价标准研究[J].中国中西医结合肾病杂志,2003(11):671~672.
[6] 刘程,王松霞,韦涌涛.IgA肾病患者尿单核细胞趋化蛋白-1的检测[J].中国医药导报,2007(36):187~188.
[7] 潘松球,孙安远.单核细胞趋化蛋白-1与IgA肾病的研究进展[J].医学综述,2006,(5):274~276.
[8] 傅鹏,于光,许静,等.来氟米特联合激素延缓进展型IgA肾病肾功能减退的临床研究[J].临床内科杂志,2006,(11):731~733.
[9] 卫建平,王秋红,王晨,等.肝细胞生长因子转化生长因子-β1在IgA肾病肾组织的表达及意义[J].中国药物与临床,2010,10(4):381~384.
[10] 袁鲁晓.环孢素A联合不同剂量泼尼松治疗进展性IgA肾病及其对血清IL-18、ICAM-1的影响[J].慢性病学杂志,2017,18(2):205~207.
[11] 杨有芹,常晓东,程茂丽,等.来氟米特联合糖皮质激素治疗进展性IgA肾病的疗效及对VCAM-1水平的影响[J].现代生物医学进展,2016,16(11):2134~2137.
[12] 师锁柱,陈香美,秦晓新,等.细胞粘附分子在IgA肾病患者肾组织中的表达-定量免疫组织化学研究[J].中国组织化学与细胞化学杂志,1995,(4):399~402,443. |
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2018, Vol. 24 
