To Compare The Clinical Efficacy Of Hormone Combined With Cyclophosphamide In The Treatment Of Idiopathic Membranous Nephropathy

Objective: Currently,there is no unified treatment scheme for idiopathic membranous nephropathy,and the treatment prognosis is quite different.According to the 2012 guidelines for improving the prognosis of global kidney disease,it is recommended to treat idiopathic membranous nephropathy with hormone combined with oral cyclophosphamide or calcineurin inhibitor,but currently oral hormone combined with static cyclophosphamide is used in multiple treatment centers.The clinical efficacy and safety of oral glucocorticoid combined with static cyclophosphamide or oral cyclophosphamide in the treatment of idiopathic membranous nephropathy were observed.Methods: A prospective,randomized controlled study was conducted to include 50 patients diagnosed with IMN by concurrent renal biopsy in nanhu district of shengjing hospital from January 2017 to May 2018.The selected patients were randomly divided into 25 patients in the oral cyclophosphamide group and 25 patients in the intravenous cyclophosphamide group.Prednisone 0.8-1.0mg/(kg d)was administered orally,and the dose gradually decreased during 8-12 weeks.Compound cyclophosphonide 0.1g/d was given orally in the CXT group,with a median cumulative dose of 10.88 g.Each time 0.6g was given to the CXT group in the quiescent point group once every three weeks,and the dose was changed to 1.0g once a month after three consecutive times,with a median cumulative amount of 7.4g.The occurrence of 24 h urinary protein quantitation,serum albumin,liver and kidney function and adverse events in the two groups were observed,and the remission rate and drug safety of the two groups were compared at 6 months and12 months of treatment.Results: 1.There were 25 patients in the oral group and 25 patients in the static group,and 15 males and 10 females in the two groups,respectively.The 24-hour urinary protein quantitation was 9.57 3.17g/L and 10.99 4.37g/L,respectively.There was no significant difference between the two groups in general,pathological and comorbidity(P>0.05).2.Albumin at 12 months of treatment in the oral group and the static point group was significantly higher than that before treatment(P<0.05),and urine protein at 12 months of treatment was significantly lower than that before treatment(P<0.05).However,therewas no significant difference in renal function between 12 months before and after treatment(P>0.05).3.The effective rate of the oral group at 1,3 and 6 months was higher than that of the static point group,and the effective rate of the static point group at 12 months was 72%higher than that of the oral static point group 64%,but there was no significant difference(P>0.05).4.The incidence of adverse reactions in the static point group was relatively low,but there was no significant statistical difference(P>0.05).Conclusions: The treatment effect was faster in the oral group,but the effect was better in the static point group at the follow-up of 12 months,and the safety in the static point group was higher than that in the oral group.