Effects of Tripterygium wilfordii Induction Therapy to IgA Nephropathy Patients with Heavy Proteinuria
Effects of Tripterygium wilfordii Induction Therapy to IgA Nephropathy Patients with Heavy Proteinuria
复制标题
DOI：
10.1248/bpb.b17-00134
复制
发表时间：
2017-11-01
影响因子：
2
通讯作者：
Chen, Xin
中科院分区：
文献类型：
--
作者：
Wang, Zhen;Yu, Chao;Chen, Xin
虽然已有一些新药被开发出来，但雷公藤仍是一种难治性新药。（TWHF）具有相对较低的价格和较少的副作用的优点。然而，雷公藤多甙（尤其是120 mg/d剂量）治疗伊加肾病的疗效和安全性尚不明确。对49例接受诱导治疗的IgAN患者进行了一项队列研究。将患者分为三组：泼尼松组（PRE）、常规剂量雷公藤多甙组（CTW）和双倍剂量雷公藤多甙组（DTW）。比较两组患者的临床表现、实验室检查、组织学表现及预后。我们发现，尿蛋白排泄和N-乙酰-β-D-氨基葡萄糖苷酶（NAG）和视黄醇结合蛋白（RBP）的升高率在所有组中均显著。各组间的组织病理学变化和肾功能不全发生率均无显著差异。PRE组（69.2%）和DTW组（87.5%）患者达到完全缓解; CTW组无患者达到完全缓解。此外，DTW组的总缓解率显著高于CTW组。PRE和DTW组的低蛋白血症程度明显改善。所有患者均耐受良好，未观察到严重不良事件。我们的研究结果表明，诱导治疗与双剂量TWHF显着提高IgAN患者的反应率与重蛋白尿，并没有显着增加副作用。
Although some new drugs have been developed, Tripterygium wilfordii How F. (TWHF) has the merits of relatively lower price and fewer side effects. Unfortunately, the efficacy and safety of the TWHF (especially dosage 120 mg/d) in the immunoglobulin A (IgA) nephropathy (IgAN) are still lacking. A cohort study including 49 IgAN patients with heavy proteinuria who received induction therapy was undertaken. Patients were divided into three groups: Prednisone (PRE), conventional-dose TWHF (CTW) and double-dose TWHF (DTW). The clinical features, laboratory data, histological manifestations and outcomes of the groups were compared. We found that urinary protein excretion and rates of elevated n-acetyl-beta-D-glucosaminidase (NAG) and retinol binding protein (RBP) were prominent in all groups. Neither histopathological changes nor the rates of renal insufficiency were significantly different among groups. Patients in the PRE (69.2%) and DTW groups (87.5%) achieved complete remission; none of the CTW group did. Furthermore, the total remission rate of the DTW group was substantially higher than that of the CTW group. The degree of hypoproteinemia, improved considerably in the PRE and DTW groups. Treatment was well tolerated in all patients, and no serious adverse events were observed. Our findings suggested that induction therapy with double dose TWHF significantly improved response rates in IgAN patients with heavy proteinuria, and did not considerably increase side effects.