| 祖二梅,闫桂霞,刘新华.泼尼松与吗替麦考酚酯治疗系膜增生性IgA肾小球肾炎患者的综合干预护理分析[J].安徽医药,2018,22(6):1186-1190. |
| 泼尼松与吗替麦考酚酯治疗系膜增生性IgA肾小球肾炎患者的综合干预护理分析 |
| Comprehensive intervention nursing of prednisone and mycophenolate mofetil in the treatment of patients with mesangial proliferative IgA glomerulonephritis |
| 投稿时间：2017-07-07 |
| DOI： |
| 中文关键词: 肾小球肾炎,膜增生性 肾小球肾炎,IGA 泼尼松 吗替麦考酚酯 临床护理研究 |
| 英文关键词: Glomerulonephritis,Membranoproliferative Glomerulonephritis,IGA Prednisone Mycophenolate mofetil Clinical nursing research |
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| 中文摘要: |
| 目的 研究泼尼松与吗替麦考酚酯(Mycophenolate Mofetil,MMF)治疗系膜增生性IgA肾小球肾炎患者的护理干预价值。 方法 从2014年11月至2016年11月,接受治疗的86例被确诊患有系膜增生性IgA肾小球肾炎的患者作为研究对象。采用随机数字表法分成观察组(43例)和对照组(43例)。对照组采用泼尼松与吗替麦考酚酯治疗并加以常规护理；观察组在对照组的基础上增加综合干预护理,治疗12个月后,观察并比较两组护理干预的疗效、生理指标、血管内皮生长因子(VEGF)、基质金属蛋白酶-9(MMP-9)、耐药性、不良反应、复发率及视觉模拟评分(visual analogue scale,VAS)。 结果 治疗后观察组完全缓解占比37.21%(16例/43例)、总有效率97.67%(42例/43例),显著高于对照组16.28%(7例/43例)、86.05%(37例/43例),差异有统计学意义(χ2=4.807,3.888；P＜0.05)；治疗前各项生理指标比较差异无统计学意义,治疗后各项生理指标均有显著改善,且观察组改善幅度较对照组差异有统计学意义(t=6.417,7.227,9.760,5.595,12.125,6.399,2.907；均P＜0.05)；治疗前两组差异无统计学意义,治疗后血清VEGF和MMP-9水平均显著下降,且观察组较对照组下降更明显,差异有统计学意义(t=7.954,8.004；均P＜0.001)；两组患者在在护理前SAS评分比较差异无统计学意义,护理后观察组SAS评分显著低于对照组,差异有统计学意义(t=14.102,P＜0.001)；两组患者在治疗期间均有不良反应产生,总不良反应发生率两组差异无统计学意义 (χ2=0.551,P＞0.05)。 结论 泼尼松与MMF对系膜增生性IgA肾小球肾炎患者治疗同时并加以综合性的护理措施,不仅有效提高了治疗效率、改善了患者各项生理指标,降低了血清VEGF和MMP-9水平,同时还有效减轻了患者的焦虑心理,且安全可靠,值得临床借鉴。 |
| 英文摘要: |
| Objective To study the nursing intervention effect of Prednisone and Mycophenolate mofetil (MMF) in the treatment of patients with mesangial proliferative IgA glomerulonephritis. Methods Eighty-six patients,who were diagnosed with mesangial proliferative IgA glomerulonephritis from November 2014 to November 2016 in The First Affiliated Hospital of Xinjiang Medical University,were included in the study.They were randomly assigned into observation group (43 cases) and control group (43 cases) according to the random digital table method.The control group was treated with Prednisone and Mycophenolate mofetil therapy plus routine nursing;the observation group,on the basis of the therapy in the control group,was given comprehensive nursing intervention.After 12 months of treatment,the effect of nursing intervention physiological index,vascular endothelial growth factor (VEGF),matrix metalloproteinase -9 (MMP-9),drug resistance and adverse reaction and recurrence rate,visual analogue scale (VAS) score were compared between the two groups. Results After the treatment,the complete remission accounted for 37.21% (16 cases/ 43 cases),the total effectiveness accounted for 97.67% (42 cases/43 cases) in the observation group,which were significantly higher than the control group 16.28% (7 cases/43 cases),86.05% (37 cases/43 cases);the differences were statistically significant (χ2=4.807,3.888;P＜0.05).Physiological indexes had no statistical differences before treatment,and all physiological indexes after treatment were significantly improved,and the improvement rate in the observation group was statistically significant compared with the control group (t=6.417,7.227,9.760,5.595,2.125,6.399,2.907;all P＜0.05).There was no significant difference in serum VEGF and MMP-9 of the two groups before treatment;serum VEGF and MMP-9 after treatment were significantly decreased,and the reduction in the observation group was more significantly than the control group;the difference was statistically significant (t=7.954,8.004,P＜0.001).the SAS score before nursing had no statistical difference between the two groups,but the SAS score after nursing in the observation group was significantly lower than the control group;the difference was statistically significant (t=14.102,P＜0.001).Adverse reactions occurred during the treatment in the two groups,and the occurrence rate of the total adverse reactions was not statistically significant (χ2=0.551,P＞0.05). Conclusions Combined with comprehensive nursing measures,Prednisone and MMF in the treatment of patients with mesangial proliferative IgA glomerulonephritis and omnibus nursing measures not only effectively improve the treatment efficiency,improve the physiological index of patients,reduce the serum VEGF and MMP-9 levels,but also effectively reduce the patient′s anxiety,and it is safe and reliable,worthy of clinical reference. |
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