Clinical efficacy of different administration methods of hormone combined with cyclophosphamide in the treatment of idiopathic membranous nephropathy / 中国医师杂志

ABSTRACT

Objective:To investigate the clinical efficacy and safety of oral glucocorticoid combined with intravenous cyclophosphamide or oral cyclophosphamide in the treatment of idiopathic membranous nephropathy.Methods:According to the random number table method, 50 patients in our hospital were divided into oral cyclophosphamide group (oral group) and intravenous cyclophosphamide group (intravenous group). The oral group was treated with prednisone and compound cyclophosphamide tablets, while the intravenous group was given prednisone and intravenous injection of cyclophosphamide. The 24-hour urinary protein, serum albumin, liver and kidney function and adverse events were observed before treatment and 1, 3, 6 and 12 months after treatment. The remission rate and drug safety of the two groups were compared.Results:After 3 months of treatment, the effective rate of oral group was 40%, which was significantly higher than that of intravenous group (4%). After 6 months of treatment, the effective rate of oral group (52%) was higher than that of intravenous group (44%). After 12 months of treatment, the effective rate of intravenous group (72%) was higher than that of oral group (64%), with no statistically significant difference ( P>0.05). Before treatment, there were no significant differences in albumin, urea nitrogen, creatinine, Cystatin C, glomerular filtration rate and 24-hour urine protein between the oral group and the intravenous group ( P>0.05). After 12 months of treatment, the level of albumin in the oral group and the intravenous group was significantly higher than that before treatment ( P<0.05), and the 24-hour urine protein level was significantly lower than that before treatment ( P<0.05). The total incidence of adverse reactions in the intravenous group was lower than that in the oral group ( P<0.05). Conclusions:Hormone combined with intravenous infusion of cyclophosphamide has better long-term efficacy and higher safety in the treatment of idiopathic membranous nephropathy.