Abstract
Objective To evaluate the clinical efficacy and safety of valsartan and methylprednisolone combined with cyclophosphamide for treatment of IgA nephropathy with prevailing proteinuria. Methods 118 case of IgA nephropathy patients with prevailing proteinuria were divided into the research group(60 cases)and control group (58 cases)according to random number table. Patients in the control group were given valsartan capsules(80mg／d)and methylprednisolone tablets(1mg·kg-1·d-1),patients in the research group were given cyclophosphamide tab-lets on the basis of control group(0.5～1.0g／m2,1 time／month, a total of 10 times). All the patients were treated for 12 months. The clinical efficacy, 24h urine protein quantitative and plasma-albumin(ALB)were observed before and after treatment. Results After treatment, the clinical efficacy of research group and control group were 79.33% and 43.10%, the data of research group was significantly higher than that of the control group(χ2＝19.401,P＜0.01), the 24h urine protein quantitative of the research group was significantly decreased from(2.0±1.3)g／24h before treatment to(0.9±0.2)g／24h in the 12 month after treatment(t＝7.184,P＜0.01),the ALB of the research group was significantly increased from(32.2±4.2)g／L before treatment to(39.5±4.8)g／L in the 12 month after treat-ment(t＝5.335,P＜0.01),the 24h urine protein quantitative of the research group afer 4,6,8,10,12 month were significantly lower than those in the control group(t＝3.461,3.854,4.021,3.976,3.365,all P＜0.05), the ALB of research group afer 8,10,12 month were significantly higher than those in control group(t＝3.850,5.020,5.560,all P＜0.05). Conclusion Valsartan combined methylprednisolone can more effectively reduce urinary protein and pro-tect renal function for the treatment of IgA nephropathy. Key words: Glomerulonephritis,IGA; Valsartan; Cyclophosphamide; Proteinuria; Prealbumin
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