| Objective: To investigate the efficacy and clinical prognosis of glucocorticoids combined with cyclophosphamide in the treatment of idiopathic membranous nephropathy with diabetes.Methods: Select patients with idiopathic membranous nephropathy confirmed by renal biopsy in our hospital from January 2016 to December 2017,and exclude patients with secondary kidney disease,total 105 patients.Among them,41 patients with diabetes were in the observation group.(IMN + DN group,5 people with pathological results including diabetic nephropathy;IMN + DM group,36 people without diabetic nephropathy).A total of 64 patients with normal blood glucose were included in the control group.There was no significant difference in basic data among patients in each group.After diagnosis,all patients were given oral glucocorticoid combined with intravenous cyclophosphamide shock.Monitor 24-hour urine protein quantification,serum albumin,serum creatinine,and other changes at 3,6,and 12 months after treatment and assess remission rate and adverse reactions.Results: After treatment for 12 months,the urine protein level was significantly lower than before,and the serum albumin level was significantly increased(P <0.01).Patients in the observation group had a remission rate of 12.19%,54.09%,and 63.41% at 3 months,6 months,and 12 months,which showed a significant remission compared with that before treatment(P <0.01).The curative effect of the control group was better than that of the observation group(P <0.05).Both IMN + DN group and IMN + DM group got relieved,and there was no significant difference in efficacy(P> 0.05).The risk of adverse effect did not increase exactly.Conclusion: Glucocorticoids combined with cyclophosphamide are effective in the treatment of idiopathic membranous nephropathy with diabetes.Clinically,for patients with diabetes complicated by kidney disease,it is still quite important to have a kidney biopsy as early as possible to make a clear diagnosis. |
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