钙神经蛋白抑制剂治疗儿童狼疮性肾炎的新进展  

Progress in the treatment of young patients with lupus nephritis using calcineurin inhibitors

作　　者：魏伟[1] 夏正坤[1] 

机构地区：[1]南京军区南京总医院儿科,210002

出　　处：《中华临床医师杂志（电子版）》2014年第2期77-80,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：国家自然科学基金(81270800)

摘　　要：激素联合环磷酰胺静脉冲击治疗是儿童狼疮性肾炎的经典治疗方案,但疾病复发仍难控制,且环磷酰胺有骨髓毒性、生殖毒性以及继发肿瘤的风险,使其应用受到限制。治疗相关副作用是免疫抑制剂治疗狼疮性肾炎的主要治疗风险,因此选择安全有效的方案仍是临床医师治疗儿童狼疮性肾炎患者时面临的一大困境。钙神经蛋白抑制剂如环孢素A和他克莫司治疗狼疮性肾炎有效,且安全性较好。含他克莫司的多靶点治疗方案是近年来的热点。本文就钙神经蛋白抑制剂治疗儿童狼疮性肾炎的新进展作一综述。Steroids with intermittent pulses of intravenous cyclophosphamide is standard treatment protocol for pediatric-onset lupus nephritis, but disease flare is still frequent and difficult to control. Cyclophosphamide is associated with myelotoxicity, gonadal toxicity, and an increased risk of secondary malignancy, which limits its clinical usage. Since therapy-related adverse events are a major concern of immunosuppressive agents for the patients with lupus nephritis, how to establish a safe and effective treatment protocol is a dilemma for physicians treating young patients. Calcineurin inhibitor, such as cyclosporine A and tacrolimus, are effective and relatively safe for lupus nephritis. Tacrolimus containning multidrug therapy is becoming a hot spot in recent years.

关 键 词：狼疮肾炎 儿童 钙神经蛋白抑制剂 多靶点治疗 

分 类 号：R726.9[医药卫生—儿科]