他克莫司联合激素治疗V型狼疮性肾炎临床研究  

Study of tacrolimus combined with prednisone in patients with type V lupus nephritis

作　　者：张艳霞 

机构地区：[1]武汉市第三医院光谷关山院区内科,430074

出　　处：《大众健康（理论版）》2012年第11期54-56,共3页

摘　　要：目的：探讨他克莫司联合激素治疗V型狼疮性肾炎的疗效和安全性。方法：将45例V型狼疮性肾炎患者随机分为研究组和对照组，分别采用他克莫司或环磷酰胺联合激素治疗，观察两组治疗前后实验室指标的变化及用药期间的不良反应。Ⅱ结果：两组治疗9个月后的狼疮疾病活动性指数、尿蛋白定量、尿沉渣红细胞计数和抗dsDNA阳性率较治疗前均显著下降；而血清白蛋白、补体水平较治疗前均显著升高；研究组更为显著。研究组有效率显著高于对照组，上述比较均有统计学意义（P〈0．05）；研究组糖代谢异常的发生率高于对照组，而心律失常、肝功能损伤、白细胞下降及感染低于对照组，未出现月经紊乱，但上述不良反应的发生率组间比较差异均无统计学意义（P〉O．05）。结论：他克莫司是诱导治疗V型狼疮性肾炎的一种有效的免疫抑制剂，较之环磷酰胺起效快，不良反应轻。Objective：To investigate the efficacy and safety of tacrohmus combined with glucocorticoid for inductive therapy of type V lupus nephritis. Methods：Forty-five patients with type V lupus nephritis were randomly divided into study group （23 cases）and control group （22 cases）,and they received treatment of either tacrohmus combined with glucocorticoid or cyclophosphamide combined with glucocorticoid, respectively. The changes of laboratory tests and adverse reactions before and after were observed. Resuhs：After treatment for 9 months,the systemic lupus erythematosus disease activity index,urinary protein quantitation, urinary sediment RBC count and anti dsDNA positive rate in two groups were significantly decreased than those before treatment （P〈0.05）. While serum albumin,complement C3and C4 levels were significandy increased than those before treatment （P〈O. 05）. The study group increased more significantly. The efective rate in study group was significantly higher than that in control group （P〈O.05）. The incidence rate of abnormal glucose metabolism in study group was higher than that in control group, and the incidence of arrhythmia,liver injury,reduction of blood WBC and infection were lower than that in control group. In addition,menstrual disorders did not occur in study group,but the incidence rate of side elects between two groups had no significant diference （P〉0.05）. Conclusion：Tacrolimus is an effective immunosuppressant for inductive therapy of type V lupus nephritis with quick response and less adverse effects.

关 键 词：狼疮性肾炎 他克莫司 环磷酰胺 

分 类 号：R593.242[医药卫生—内科学]