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目的探讨肾移植受者术后蛋白尿临床诊治的效果,并观察其不良反应。方法对131例肾移植术后蛋白尿患者行移植肾穿刺活体组织检查,根据不同病因应用糖皮质激素类药物或调整免疫抑制方案及改善微循环等相应临床治疗,评价其临床疗效和安全性。结果治疗后24h尿蛋白定量、血肌酐、肌酐清除率、血尿素氮分别为(0.48±0.36)g/L、(119.88±34.15)μmon/L、(82.23±48.79)ml/min、(4.42±1.77)mmon/L,与治疗前比较,差异有统计学意义(P<0.05);治疗后排斥反应、新发/复发性肾小球肾炎和缺血再灌注损伤组的总有效率与无效率比较差异有统计学意义(P<0.05);治疗期间未发生严重不良反应。结论根据移植肾穿刺结果,应用糖皮质激素类药物或者调整免疫抑制方案及改善微循环等药物治疗对肾移植术后蛋白尿进行治疗,其临床疗效好,不良反应较少。
Objective To investigate the effect of clinical diagnosis and treatment of proteinuria in renal transplant recipients and to observe its adverse reactions. Methods 131 cases of renal allograft patients with proteinuria underwent renal biopsy in vivo. The clinical efficacy and safety were evaluated according to different causes of glucocorticoid drugs or adjusting immunosuppressive regimen and improving microcirculation. Results The proteinuria, serum creatinine, creatinine clearance and blood urea nitrogen were (0.48 ± 0.36) g / L, (119.88 ± 34.15) μmon / L, (82.23 ± 48.79) ml / min and (4.42 ± 1.77) mmon / L, compared with before treatment, the difference was statistically significant (P <0.05); after treatment, rejection, new onset / recurrent glomerulonephritis and ischemic reperfusion injury group total effective rate and inefficiency The difference was statistically significant (P <0.05); no serious adverse reactions occurred during the treatment. Conclusion According to the results of transplanted renal biopsy, glucocorticoid drugs or adjusting immunosuppressive regimens and improving microcirculation and other drug treatments for the treatment of albuminuria after renal transplantation have good clinical efficacy and few adverse reactions.