目的 探討注射用紅花黃色素聯(lián)合環(huán)孢素A和潑尼松治療老年膜性腎病的臨床療效。方法 選取2015年9月-2016年9月在邯鄲市中心醫(yī)院進(jìn)行治療的老年膜性腎病患者98例，依據(jù)用藥的差別分成對(duì)照組（49例）和治療組（49例）。對(duì)照組口服醋酸潑尼松片，0.5 mg/（kg·d），2次/d，同時(shí)口服環(huán)孢素軟膠囊，2 mg/（kg·d），2次/d。治療組在對(duì)照組的基礎(chǔ)上靜脈滴注注射用紅花黃色素，100 mg加入生理鹽水250 mL，1次/d。兩組患者均治療4周。評(píng)價(jià)兩組患者臨床療效，同時(shí)比較治療前后兩組患者相關(guān)指標(biāo)和血清指標(biāo)。結(jié)果 治療后，對(duì)照組總有效率為81.63%，顯著低于治療組的95.92%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者24 h尿蛋白（24 h UTP）、血肌酐（Scr）、尿素氮（BUN）、總膽固醇（TC）和三酰甘油（TG）水平均明顯降低，而血清白蛋白（ALB）明顯增高，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組上述指標(biāo)改善程度顯著優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者血清基質(zhì)金屬蛋白酶抑制因子-1（TIMP-1）水平降低，而基質(zhì)金屬蛋白酶-9（MMP-9）水平增高，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組比對(duì)照組改善更明顯，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 注射用紅花黃色素聯(lián)合環(huán)孢素A和潑尼松治療老年膜性腎病效果顯著，可明顯改善患者腎功能，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To study the clinical efficacy of Safflower Yellow for injection combined with cyclosporine and prednisone in treatment of elderly senile membranous nephropathy. Methods Patients (98 cases) with membranous nephropathy in Handan Central Hospital from September 2015 to September 2016 were divided into control (49 cases) and treatment (49 cases) groups based on different treatments. Patients in the control group were po administered with Prednisone Acetate Tablets, 0.5 mg/(kg·d), twice daily, at the same time they were po administered with Ciclosporin Soft Capsules, 2 mg/(kg·d), twice daily. Patients in the treatment group were iv administered with Safflower Yellow for injection on the basis of the control group, 100 mg added into normal saline 250 mL, once daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the relative indexes and serum indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 81.63%, which was significantly lower than 95.92% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the 24 h UTP, Scr, BUN, TC and TG levels in two groups were significantly decreased, but the serum ALB level was significantly increased, and the difference was statistically significant in the same group (P<0.05). And the improvement of these indicators in the treatment group was significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the TIMP-1 level in two groups was significantly decreased, but the MMP-9 level was significantly increased, and the difference was statistically significant in the same group (P<0.05). And the levels in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Safflower Yellow for injection combined with cyclosporine and prednisone has significant clinical efficacy in treatment of senile membranous nephropathy, can obviously improve the renal function, which has a certain clinical application value.