CTBP1 has been demonstrated as a co-repressor in the transcriptional regulation of downstream genes and is involved in various cell process. However, the mechanism of CTBP1 in the progression of prostate cancer is still unclear. Here, we aim to investigate how CTBP1 exerts its role in prostate cancer progression, especially how CTBP1 was regulated by the upstream genes. We found that CTBP1 was highly expressed in prostate cancer and promoted the cell viability, migration, invasion and glycolysis of prostate cancer cells. CDH1 was verified to be the target of CTBP1. We determined that CTBP1 could directly bind with SP1 to inhibit the transcription of CDH1. Moreover, succinylation of CTBP1 was found to be up-regulated in prostate cancer cell. Further studies demonstrated that KAT2A promotes the succinylation of CTBP1 and mediates the transcription suppressing activity of it. In addition, the K46 and K280 was confirmed to be the two sites that regulated by KAT2A. In vivo studies further indicated that CTBP1 could promote the growth of prostate cancer, and this effect of CTBP1 could be partially reversed by KAT2A knockdown. Taken together, we found that succinylation of CTBP1 mediated by KAT2A suppresses the inhibitory activity of CTBP1 on the transcription of CDH1, thus act as an oncogene.

跌倒是我国65岁以上老年人伤害及死亡的首位原因.据估算,我国每年有4000多万老年人至少发生1次跌倒,老年人跌倒后的死亡率随年龄的增加急剧上升,但跌倒的发生并非意外,是完全可以预防和控制的.

Background: This study aims to explore the combined effect of frailty and the estimated glomerular filtration rate (eGFR) and non-elective hospital readmission in elderly inpatients. Methods: A total of 400 elderly patients were selected. The Fried scale was used to assess frailty. The patients were divided into a non-frailty group and a frailty group. They were divided into a normal eGFR group and a eGFR decreased group. Finally, the patients were divided into the following four groups: Group A (no frailty + eGFR normal); Group B (no frailty + eGFR decreased); Group C (frailty + eGFR normal); and Group D (frailty + eGFR decreased). Results: The results of the follow-up survival analysis showed the non-elective hospital readmission within 6 months of discharge. Group A, Group B, Group C, and Group D had an incidence of 21%, 26%, 24%, and 36%, respectively. The Kaplan-Meier curves showed the event-free survival rates of Group A and Group C were higher than that of Group D, and there was no significant difference between Group B and Group D. The risk of non-elective hospital readmission within 6 months in patients with a decreased eGFR was 1.777 times higher than that in patients with a normal eGFR [95% confidence interval (CI): 1.001-3.154], while the risk of non-elective hospital readmission within 6 months in frail patients and non-frail patients did not differ significantly. The multivariate Cox regression analysis showed that the risk of non-elective hospital readmission in Group D was 2.295 times higher than that in Group A (95% CI: 1.096-4.810), and the difference was statistically significant. The risk of non-elective hospital readmission in Group B was 1.401 times of that in Group A (95% CI: 0.665-2.953), while that in Group C was 91.8% (95% CI: 0.403-2.092), but the differences were not statistically significant. Conclusions: A decline in eGFR is associated with non-elective hospital readmission in elderly inpatients within 6 months; however, frailty is not associated with non-elective hospital readmission. The combined effect of frailty and eGFR in elderly inpatients is related to non-elective hospital readmission.

前列腺癌是老年男性常见的肿瘤之一,它与代谢综合征之间密切相关.流行病学及病理生理学机制表明代谢综合征在前列腺癌的发生发展中发挥着重要的作用,同时还与老年前列腺癌患者的临床预后有关,另外,一些治疗代谢综合征的药物可以预防或者改善前列腺癌患者的预后.该文将从流行病学、病理生理学相关机制以及治疗进展3个方面对老年前列腺癌与代谢综合征之间的关系进行综述.

Objective:To systematically review the efficacy and safety of new oral anticoagulants(NOACs)for the treatment of patients over 70 years with atrial fibrillation.Methods:Studies comparing NOACs(dabigatran, rivaroxaban, apixaban, ximelagatran and edoxaban)versus warfarin for the treatment of patients over 70 years with atrial fibrillation were searched through databases including PubMed, Embase and the Cochrane Library, from the earliest electronic records to those published in March 2021.Stata15.0 software was used for meta-analysis.Results:A total of 19 studies and 215 471 patients were included.Meta-analysis results showed that, compared with warfarin, either a low-dose(110 mg)or a standard-dose(150 mg)of dabigatran reduced the risk of stroke/systemic embolism(SSE)in patients over 70 years with atrial fibrillation.A standard-dose of dabigatran did not decrease the risk of major bleeding, but a low dose was able to achieve it.A standard-dose(20 mg)of rivaroxaban could considerably reduce the risk of SSE in geriatric patients over 70 years with atrial fibrillation without increasing the risk of major bleeding.A standard-dose(5 mg)of apixaban could considerably decrease the risk of SSE and major bleeding in patients over 70 years with atrial fibrillation; A standard-dose(36 mg)of ximelagatran was as effective as warfarin in decreasing the incidence of SSE in patients over 70 years with atrial fibrillation, but could also considerably decrease the risk of major bleeding; A low-dose(15-30 mg)or a standard-dose(30-60 mg)of edoxaban decreased the incidence of SSE in patients over 70 years with atrial fibrillation, as did warfarin, but edoxaban considerably decreased the risk of major bleeding.Conclusions:Compared with warfarin, most of new oral anticoagulants show good efficacy in patients over 70 years old with atrial fibrillation, NOACs given at standard doses increase the risk of major bleeding, but at low doses can realize both efficacy and safety.

目的 观察雷公藤甲素(triptolide,Tp)干预后脂多糖诱导的小鼠肾脏足细胞上皮-间质转化(epithelial-mesenehymal transition,EMT)相关蛋白表达变化,探讨Tp对小鼠肾脏足细胞EMT的抑制作用.方法 采用CCK-8法检测小鼠肾脏足细胞活性,确定脂多糖浓度为5 μg/L,Tp浓度为10μg/L.将小鼠肾脏足细胞分为对照组(不作处理)、脂多糖组(5 mg/L脂多糖溶液)和Tp+脂多糖组(10 μg/L Tp+5 mg/L脂多糖溶液),处理24 h,采用Western blot法检测Toll样受体(Toll-like receptor,TLR)4、基质金属蛋白酶(matrix metalloproteinase,MMP)-9、紧密连接蛋白-1(zonula occluden-1,ZO-1)蛋白相对表达量.结果 脂多糖组TLR4(1.24±0.04)、MMP-9 (0.87±0.03)蛋白相对表达量均高于对照组(1.07±0.03、0.61±0.16)和Tp+脂多糖组(0.98±0.11、0.60±0.01) (P＜0.05),ZO-1蛋白相对表达量(0.59±0.10)均低于对照组(0.88±0.14)和Tp+脂多糖组(0.82±0.14) (P＜0.05);Tp+脂多糖组TLR4、MMP-9、ZO-1蛋白相对表达量与对照组比较差异均无统计学意义(P＞0.05).结论 Tp可下调小鼠肾脏足细胞TLR4、MMP-9表达,上调ZO-1表达,抑制脂多糖诱导的EMT.

目的 探索老年住院病人认知障碍与冠心病的关系.方法 选取678例研究对象,根据是否患冠心病将研究对象分为冠心病组(n=203)与非冠心病组(n=478).采用MoCA、MMSE对认知状态进行评估,采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(24项版)(HAMD-24评分)对焦虑抑郁状态进行评估,采用Barthel指数对日常生活活动能力(ADL)进行评估.采用Logistic回归分析冠心病的影响因素.结果 冠心病组MoCA、MMSE、Barthel指数低于非冠心病组,而HAMA评分、HAMD评分高于非冠心病组,差异具有统计学意义(P<0.05).多因素Logistic回归提示,MoCA评分高是冠心病的保护因素(OR=0.962,95％CI:0.931～0.994),高龄(OR=1.031,95％CI:1.004～1.058)、HAMA评分高(OR=1.042,95％CI:1.014～1.071)、高血压病程长(OR=1.024,95％CI:1.010～1.038)、糖尿病病程长(OR=1.036,95％CI:1.013～1.060)是冠心病的危险因素(P<0.05).结论 老年住院病人的冠心病可能与认知障碍、焦虑状态有关.

Objective:To investigate the relationship between sarcopenia and early renal dysfunction in elderly patients with type 2 diabetes mellitus(T2DM).Methods:A total of 198 elderly patients with T2DM aged over 60 years undergoing treatment in the Geriatric Department of Beijing Hospital from July 2018 to July 2019 were enrolled in this retrospective case-control study.The estimated glomerular filtration rate(eGFR)is calculated according to the CKD-EPI Cr-Cys formula.Based on the eGFR, the patients were divided into normal renal function group(n=63, in CKD 1 stage)and mild renal dysfunction group(n=135, in CKD 2-3a stage). All subjects underwent physical examination, laboratory examination and dual energy X-ray bone density examination. Results:The age, weight, body mass index, abdominal circumference, serum creatinine, cystatin C, uric acid, diastolic pressure, the proportions of diabetes and hypertension were lower, and the high-density lipoprotein cholesterol, appendicular skeletal muscle mass(ASM)and skeletal muscle mass index(SMI)were higher, in the normal renal function group than in the mild renal dysfunction group( P<0.05 or 0.01). Spearman correlation analysis showed that eGFR was positively correlated with SMI( r=0.343, P<0.01). Logistic regression analysis showed that body weight( OR=1.318, 95% CI: 1.091-1.594), uric acid( OR=1.007, 95% CI: 1.001-1.012), diastolic blood pressure( OR=1.072, 95% CI: 1.033-1.112), years of diabetes( OR=1.075, 95% CI: 1.013-1.142)were risk factors, and the LSM( OR=0.136, 95% CI: 0.047-0.392)and SMI( OR=0.778, 95% CI: 0.703-0.860)were protective factors for the early renal dysfunction in elderly patients with T2DM. Conclusions:Elderly patients with T2DM are often co-existed with sarcopenia.Sarcopenia is associated with early renal dysfunction in elderly patients with T2DM.

With the acceleration of the aging process in China, the incidence rates of coronary heart disease and cerebral infarction have significantly increased.And iodine contrast agent is often used in imaging diagnosis and percutaneous intervention therapy.The contrast medium is filtered from the glomerulus in its original form and is not absorbed by renal tubules.However, the accumulation of iodine contrast medium in the kidney can lead to acute kidney injury.Kidney is one of the most important excretory and endocrine organs in human body.The prevention and treatment of contrast-induced nephropathy(CIN)have been widely concerned.The incidence rate of contrast-induced renal damage is higher and the prognosis is poorer in the elderly than in the non-elderly due to the decline of organ function in the elderly.At present, the mechanism of action for oxygen free radicals in CIN of the elderly is still unclear.This article reviews the researches on the role of oxygen free radical in CIN of the elderly studied by domestic and foreign scholars in recent years.

Objective:To compare the application of three different glomerular filtration rate(eGFR)-estimating equations in the elderly aged 60 years and over.Methods:The patients aged ≥ 60 years in our hospital from January 2012 to October 2017 were included as research subjects who underwent three GFR detection(as measured GFR i. e.mGFR)of serum creatinine(Scr), serum cystatin C(sCysC)and GFR by 99mTc-DTPA renal dynamic imaging.The advantages and disadvantages of each GFR-estimating(eGFR)equation in the elderly patients were compared.Results:A total of 122 patients were enrolled, including 90 males(73.8%), with a median age of 77 years.The median Scr and sCysC were 109 μmol/L and 1.39 mg/L, respectively, with their average of mGFR being(45.70±18.91)ml·min -1·1.73m -2.Overall, each eGFR-Scr equation over-estimated the GFR in varying degrees.In eGFR-Scr, full age spectrum equation(FAS)-Scr had the smallest bias(2.34)and the best accuracy(P30 75.4%), followed by Berlin Initiative Study(BIS)-Scr(P30 71.3%). In eGFR-CysC, the P30 of FAS-CysC and chronic kidney disease(CKD)-Epidemiology Collaboration(EPI)-CysC were 75.4% and 71.3%, respectively, and the accuracy of eGFR-CysC was comparable to that of BIS-Scr and FAS-Scr.In eGFR-combi, the bias of FAS-combi was the smallest(1.10), and the accuracy of FAS-combi, BIS-combi and CKD-EPI-combi was comparable, the P30 was 81.1%, 79.5% and 74.6%, respectively, and the P30 of FAS-combi and BIS-combi was higher than that of eGFR-Scr and eGFR-CysC.In the 60-80 age group, the accuracy of FAS-combi and BIS-combi was the best, P30 was 77.8% and 76.4% respectively, while, the accuracy of other equations were poor.In patients ≥ 80 years old, except for the modification of diet in renal disease(MDRD)equations and CKD-EPI-scr equation, the accuracy of other equations was acceptable, among which the accuracy of eGFR-combi equation was the best, and the P30 of FAS-combi, BIS-combi and CKD-EPI-combi were 86.0%, 84.0% and 80.0%, respectively. Conclusions:In elderly patients aged 60 years and over, the application of eGFR-combi equation is better than that of the respective eGFR-Scr and eGFR-CysC equations.The FAS equation has the best bias and accuracy, followed by the BIS equation.

Objective:To increase the understanding of neuroleptic malignant syndrome, rhabdomyolysis and acute renal injury in advanced-aged patients with Parkinson's disease after abdominal surgery.Methods:We report a case of malignant syndrome, rhabdomyolysis and acute renal injury in an 85-year-old patient with Parkinson's disease after abdominal surgery in our department.The diagnosis and successful treatment experience were summarized, and a literature review was conducted.Results:The body temperature was as high as 40.5℃ in this patient, accompanied by stiffness, sustained involuntary shaking, increased muscle tone, serum creatine kinase at 104 615 U/L, tachycardia, low blood pressure, accelerated breathing rate, disturbance of consciousness, excessive sweating and other clinical manifestations, which met the diagnostic criteria for neuroleptic malignant syndrome.The patient had complications including concurrent rhabdomyolysis, acute renal injury and shock.The emergency was resolved after an early diagnosis and proactive treatment.Conclusions:If patients with Parkinson's disease have a high fever with rigidity or sudden aggravation within a short period of time after medication, the possibility of neuroleptic malignant syndrome should be considered and the causes should be screened.

随着社会老龄化,舒缓医疗也在不断发展,尽管舒缓医疗在很多经济发达的国家已经获得很多的关注,然而在中国却发展缓慢,人们对舒缓医疗的认识和教育还很局限,同时也缺少从事舒缓医疗的专业人员,对于舒缓医疗的教育也很受限.因此本文综述了舒缓医疗目前的发展现状,以及在中国发展舒缓医疗的前景和挑战.

Objective:To compare the advantages and disadvantages of several formulas for estimated glomerular filtration rate (eGFR) based on serum creatinine in elderly patients with chronic kidney disease (CKD) over 60 years old.Methods:CKD patients aged≥60 years old in Beijing Hospital from January 2012 to October 2017 were selected as subjects. Measured glomerular filtration rate (mGFR) was detected by 99mTc-DTPA renal dynamic imaging and used as a reference standard. According to the mGFR value, the patients were divided into 4 groups: mGFR<30 ml·min -1·(1.73 m 2) -1 group, 30≤mGFR<45 ml·min -1·(1.73 m 2) -1 group, 45≤mGFR<60 ml·min -1·(1.73 m 2) -1 group and mGFR≥60 ml·min -1·(1.73 m 2) -1 group. The deviation of each formula was compared by Bland-Altman scatter chart, and the accuracy of each formula was evaluated by the proportion of eGFR within mGFR (1±30%) ( P30) and root mean square error ( RMSE). Wilcoxon paired rank sum test was used to compare the deviation of each formula, and McNemar test was used to compare the difference of P30 among these formulas. Results:A total of 628 patients with CKD were enrolled in this study. The median age was 76.0(71.0, 81.0) years old. The median serum creatinine and mGFR were 110.0(86.0, 152.0) μmol/L and 42.90(29.88, 55.68) ml·min -1·(1.73 m 2) -1, respectively. Each eGFR formula based on serum creatinine overestimated glomerular filtration rate in varying degrees. Among them, the accuracy of Berlin Initiative Study (BIS) formula and full age spectrum (FAS) formula was the best ( P30 were 68.3% and 68.0% respectively), followed by the Chinese race coefficient of Chronic Kidney Disease Epidemiology Collaboration (C-CKD-EPI) formula ( P30 was 65.4%). The accuracy of the other formulas was poor. In terms of deviation, C-CKD-EPI formula was the best (0.27). In the group of mGFR<30 ml·min -1·(1.73 m 2) -1, the accuracy of all formulas was poor, and the accuracy of FAS formula was slightly better than that of other formulas ( P30 was 51.0%). In the group of 30≤mGFR<45 ml·min -1·(1.73 m 2) -1, the deviation of C-CKD-EPI formula was the smallest (3.11). In terms of accuracy, BIS and FAS formulas were better than others, and the P30 were 64.6% and 63.0% respectively. In the group of 45≤mGFR<60 ml·min -1·(1.73 m 2) -1, the deviation of C-CKD-EPI formula was also the smallest (0.72), and the accuracy of BIS formula was the best ( P30 was 82.5%), followed by FAS formula ( P30 was 79.7%). In the group of mGFR≥60 ml·min -1·(1.73 m 2) -1, the deviation and accuracy of Xiangya formula were the best (the deviation and P30 were -0.53 and 96.5% respectively), and the P30 of BIS and C-CKD-EPI formulas were 87.6% and 87.6%, respectively. Conclusions:In the elderly patients with CKD over 60 years old, the accuracy of eGFR based on serum creatinine increases with the increase of mGFR. BIS and FAS formulas are recommended first. The accuracy of each formula is poor in patients with severe renal insufficiency.

糖尿病是一种慢性代谢性疾病,以糖脂代谢紊乱为主要特征.患病人数逐年增加,已成为全球面临的公共健康问题之一,给社会造成严重负担.糖尿病的发病机制复杂,影响因素众多,已有的传统降糖药物在血糖控制和减少或延缓并发症发生方面发挥了相当不错的作用,但是仍然存在一些局限性及不良反应.因此,更为安全、有效、具有较少副作用的新药成为研究热点,大量临床试验结果表明,一系列新型降糖药具有降糖效果的同时,还具有心血管和肾脏保护作用.同时近年来通过改变肠道微生态、代谢手术等途径治疗糖尿病也取得了新的进展.这些都预示着糖尿病治疗有望获得新的突破.

多囊肾和肾囊肿是一回事吗?当然不是,虽然都是肾脏的囊肿,但多囊肾和肾囊肿却是两种不同的疾病.多囊肾是一种常见的染色体基因异常导致的常染色体显性遗传性疾病,95％有家族遗传病史,另外5％与环境因素导致基因突变有关.如果父母一方患有多囊肾,下一代有50％的概率遗传到该病.多囊肾患者多在40岁左右出现肾功能受损,60岁以后半数患者进入终末期肾衰竭.肾囊肿好发于中老年人群,是一种人体衰老导致的肾脏表现,在30～40岁间肾囊肿的发生率为10％左右,到80岁时,肾囊肿的发生率达到50％以上.所以当20岁左有的年轻人体检出现多发囊肿,要怀疑多囊肾的可能. 如何区分多囊肾和肾囊肿?面对这两种疾病时我们应该如何处理呢?

糖尿病肾病是糖尿病主要并发症之一,目前的治疗效果不尽如人意.有研究表明,成纤维细胞生长因子1在糖尿病肾病治疗中的作用部分被验证,能够延缓糖尿病肾病的进展,但其机制尚未明确.笔者就成纤维细胞生长因子1在糖尿病肾病中的作用进行综述.

目的 探讨小鼠肾足细胞在高糖状态下硫酸酯酶1(sulfatase 1,SULF1)表达情况及其在高糖诱导肾足细胞自噬损伤中的作用机制.方法 小鼠肾足细胞根据干预方式分为对照组(采用5.5 mmol/L葡萄糖处理)、高渗组(采用5.5 mmol/L葡萄糖+19.5 mmol/L甘露醇处理)和高糖组(采用25 mmol/L葡萄糖处理),各组分别处理24 h.小鼠肾足细胞再分为空白对照组、阴性对照组和转染组,空白对照组细胞正常培养,转染组细胞转染Sul f1 siRNA,阴性对照组细胞转染negative siRNA,转染48 h.采用反转录PCR法检测各组细胞Sul f1 mRNA相对表达量,采用Western blot法检测各组细胞SULF1蛋白、微管相关蛋白1轻链3(microtubule-associated protein 1 light chain 3,LC3)-Ⅱ、LC3-Ⅰ、蛋白激酶B(protein kinase B,Akt)、磷酸化Akt(phosphorylated Akt,p-Akt)、哺乳动物雷帕霉素蛋白(mammalian target of rapamycin,mTOR)和磷酸化mTOR(phosphorylated mTOR,p-mTOR)相对表达量,比较p-Akt/Akt p-mTOR/mTOR、LC3-Ⅱ/LC3-Ⅰ比值.结果 高糖组细胞SULF1蛋白相对表达量和LC3-Ⅱ/LC3-Ⅰ (0.84±0.20、0.67±0.60)低于对照组(1.42±0.19、1.99±0.31)和高渗组(1.33±0.25、1.75±0.22) (P＜0.05),p-Akt/Akt(0.41±0.03)、p-mTOR/mTOR(0.61±0.01)高于对照组(0.21±0.02、0.27±0.05)和高渗组(0.18±0.02、0.20±0.04)(P＜0.05),对照组与高渗组比较差异均无统计学意义(P＞0.05).转染组细胞Sul f1 mRNA和SULF1蛋白、LC3-Ⅱ/LC3-Ⅰ (0.627±0.074、0.73±0.07、0.55±0.07)低于空白对照组(1.000±0.013、1.63±0.06、1.17±0.10)和阴性对照组(0.924±0.141、1.65±0.14、1.20±0.06) (P＜0.05),p-Akt/Akt(0.78±0.04)、p-mTOR/mTOR (0.58±0.01)高于空白对照组(0.30±0.04、0.44±0.03)和阴性对照组(0.34±0.03、0.44±0.04) (P＜0.05),空白对照组与阴性对照组比较差异均无统计学意义(P＞0.05).结论 高糖环境下,肾足细胞SULF1表达降低,对PI3K/Akt/mTOR信号通路的抑制作用减弱,导致通路活性增加,从而抑制自噬,致足细胞损伤;SULF1对高糖诱导的小鼠肾足细胞自噬具有保护作用.

Chronic kidney disease(CKD)increases the risks of diabetes, hypertension, heart disease and stroke in the elderly, which leads to the increase of mortality and disability rate, to the decline of the functional status and to the elevation of medical expenses, and has become an important public health problem.In recent years, comprehensive geriatric assessment of the elderly has become a research hotspot.This article reviews the application of comprehensive geriatric assessment, and lifestyle and medical intervention in elderly patients with chronic kidney disease.

BACKGROUND:Diabetes is a chronic metabolic disease characterized by disorders of glucose and lipid metabolism. Its most serious microvascular complication is diabetic nephropathy (DN), which is characterized by varying degrees of proteinuria and progressive glomerulosclerosis, eventually progressing to end-stage renal failure.OBJECTIVE:The aim of this research is to identify hub genes that might serve as genetic markers to enhance the diagnosis, treatment, and prognosis of DN.METHODS:The procedures of the study include access to public data, identification of differentially expressed genes (DEGs) by GEO2R, and functional annotation of DEGs using enrichment analysis. Subsequently, the construction of the protein-protein interaction (PPI) network and identification of significant modules were performed. Finally, the hub genes were identified and analyzed, including clustering analysis, Pearson's correlation coefficient analysis, and multivariable linear regression analysis.RESULTS:Between the GSE30122 and GSE1009 datasets, a total of 142 DEGs were identified, which were mainly enriched in cell migration, platelet activation, glomerulus development, glomerular basement membrane development, focal adhesion, regulation of actin cytoskeleton, and the PI3K-AKT signaling pathway. The PPI network was composed of 205 edges and 142 nodes. A total of 10 hub genes (VEGFA, NPHS1, WT1, PODXL, TJP1, FYN, SULF1, ITGA3, COL4A3, and FGF1) were identified from the PPI network.CONCLUSION:The DEGs between DN and control glomeruli samples may be involved in the occurrence and development of DN. It was speculated that hub genes might be important inhibitory genes in the pathogenesis of diabetic nephropathy, therefore, they are expected to become the new gene targets for the treatment of DN.

目的 探讨雷公藤多苷联合糖皮质激素治疗和单独使用雷公藤多苷或糖皮质激素治疗IgA肾病的疗效和安全性.方法 搜索电子数据库,将符合纳入标准的随机对照试验纳入研究并由两名独立研究者分别进行文献质量评价和数据的提取,数据分析采用Review Manager 5.3和Stata 14.0软件进行分析.分析的指标为24 h尿蛋白、血肌酐、尿红细胞及不良反应.结果 共纳入9项研究.Meta结果显示联合治疗组24 h蛋白尿低于单药治疗组[MD=-0.45,95％CI:-0.50～-0.40,P<0.001].联合治疗组血肌酐低于单药治疗组[MD=-14.79,95％CI:-18.18～-11.36),P<0.001].联合治疗组尿红细胞数低于单药治疗组[MD=-21.56,95％CI:-33.49～-9.63),P<0.001].联合治疗组的不良反应少于单药治疗组[RR=0.49,95％CI:0.35～0.68,P<0.001].结论 雷公藤多苷和糖皮质激素在IgA肾病的治疗中具有协同作用,联合治疗效果优于单药治疗,联合治疗不良反应低于单药治疗组.