Efficacy And Safety Of Indobufen In Preventing Arterial Thrombosis In Patients With Idiopathic Membranous Nephropathy

Background and objectivesIdiopathic membranous nephropathy(IMN)is one of the main causes of Nephrotic syndrome(NS),and its incidence rate in China is increasing year after year.Idiopathic membranous nephropathy is prone to venous and arterial thrombotic events(ATE).In recent years,more and more attention has been paid to the prevention of ATE in patients with IMN,and it is realized that the clinical focus of patients with IMN is not only end-stage renal disease.The purpose of this study was to investigate the efficacy and safety of indobufen versus aspirin in the prevention of arterial thrombosis in patients with IMN.MethodsAccording to the inclusion and exclusion criteria,60 patients with IMN treated in our hospital from October 2020 to December 2021 were split into indobufen group and aspirin group,with 30 patients in each group.The former took indobufen 100 mg orally twice a day and the latter took aspirin 100 mg orally once a day.The treatment cycle was 6 months.Blood and urine were collected before enrollment and 6 months after enrollment,including blood routine,urine routine,biochemical series,24-hour proteinuria(UTP),coagulation functions,platelet aggregation function,etc.at the same time,the number of arterial thrombosis events,bleeding events and side events of digestive system in the treatment cycle of all patients were recorded.The changes of platelet aggregation function,the recovery of primary disease,the incidence of arterial thrombosis,bleeding and adverse reactions of digestive system were compared between the two groups before and after treatment.Results(1)When the study started,a total of 60 subjects were included,30 in indobufen group and 30 in aspirin group.When the study finished,22 cases in indobufen group and 18 cases in aspirin group completed the whole study process.There was no significant difference in age,agent composition,serum creatinine,fibrinogen(FIB)and D-Dimer(P > 0.05).(2)Compared with that before treatment,plasma albumin(ALB)increased(P < 0.05),UTP and low-density lipoprotein cholesterol(LDL-C)decreased(P < 0.05),and epinephrine(EPI),collagen(Col)The platelet aggregation rate induced by arachidonic acid(AA)decreased(P < 0.05);Compared with before treatment,the level of Alb increased(P < 0.05),the platelet aggregation rate induced by AA increased(P < 0.05),the level of UTP decreased(P < 0.05),the total cholesterol(TC)decreased(P < 0.05),and the platelet aggregation rate induced by EPI decreased(P < 0.05).(3)After treatment,there was significant difference in platelet aggregation rate induced by EPI,Col and AA between the two groups(P <0.05).(4)The effect of aspirin group on platelet aggregation induced by EPI,Col and AA was greater than that of indobufen group(P < 0.05).(5)The incidence of arterial thrombosis was similar to that of adverse reactions in the two groups(P > 0.05).Conclusions(1)Indobufen can effectively prevent the occurrence of ATE in patients with IMN;(2)Indobufen has less strike on platelet aggregation rate induced by EPI,COL and AA than aspirin,and the bleeding and adverse reactions are not higher than aspirin.