他克莫司联合糖皮质激素治疗肾病综合征的疗效及对炎症因子的影响  

Efficacy of Tacrolimus Combined with Glucocorticoid in Patients with Nephrotic Syndrome and its Effect on Inflammatory Factors

作　　者：唐杰[1] 

机构地区：[1]哈尔滨医科大学附属第一医院肾内二科,黑龙江哈尔滨150000

出　　处：《医学临床研究》2017年第4期685-687,共3页Journal of Clinical Research

摘　　要：【目的】探讨他克莫司联合糖皮质激素治疗肾病综合征（NS）患者的疗效及对炎症因子的影响。【方法】86例NS患者随机分为试验组及对照组各43例，两组患者均实施糖皮质激素治疗，试验组另给予他克莫司联合治疗，观察治疗前后两组血脂[甘油三酯（TG）、血清总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-c）、高密度脂蛋白胆固醇（HDL-C）]、炎症因子[白细胞介素-1（IL-1）、IL-6、肿瘤坏死因子-α（TNF-α）]、肾功能[尿素氮（BUN）、血肌酐（SCr）、24h尿蛋白定量]及药物不良反应。【结果】治疗前两组各指标相比较无明显差异（P〉0．05）；治疗后两组TG、TC、LDL-C、IL-1、IL-6、TNF-α、BUN、SCr、24h尿蛋白定量较治疗前明显降低，HDL-C明显升高，且治疗后试验组TG、TC、LDL-C、IL-1、IL-6、TNF-α、BUN、SCr、24h尿蛋白定量较对照组降低明显，HDL-C升高明显，且差异均有显著性（P〈0．05）。两组药物不良反应发生率相比较差异无显著性（P〉0．05）。【结论】他克莫司联合糖皮质激素治疗NS可有效调节患者血脂，显著降低炎性因子表达水平，继而达到提高其肾功能的目的。[Objective] To investigate the efficacy of tacrolimus combined with glucocorticoid in the treat- ment of nephrotic syndrome and the effect on the inflammatory factors. [Methods]Eighty-six patients with ne- phrotic syndrome were randomly divided into the experimental group and the control group with 43 cases in each group. Both groups were treated with glucocorticoid, while the experimental group was additionally trea- ted with tacrolimus. The blood lipids [triglyceride （TG）, serum total cholesterol （TC）, low- density lipopro- tein （LDLC）, high-density lipoprotein （HDLC） ], inflammatory factors [interleukin -1 （IL-1）, interleukin -6 （IL-6）, tumor necrosis factor alpha （TNF-α）], renal function [blood urea nitrogen （BUN）, serum creatinine （SCr）, 24h urine protein quantitation] and adverse drug reactions were observed before and after treatment. [Results]Before treatment, all showed no significant differences between the two groups （ P〉0.05） ; After treatment, TG, TC, LDLC, IL-1, IL-6, TNF-α, BUN, SCr and 24h urine protein quantitation decreased sig- nificantly while HDLC increased significantly; After treatment, TG, TC, LDLC, IL-1, IL-6, TNF-α, BUN, SCr, 24h urinary protein in the experimental group were significantly lower than those in the control group, HDLC increased significantly, and the difference was significant （ P〈0.05）. There was no significant differ- ence in the incidence of adverse drug reactions between the two groups （ P 〉0.05）.[Conclusion] Tacrolimus combined with glucoeorticoid in the treatment of nephrotie syndrome can significantly reduce the expression of inflammatory factors and improve the renal function of patients by effectively regulating the blood lipid levels.

关 键 词：他罗利姆/治疗应用 糖皮质激素类/治疗应用 肾病综合征/药物疗法 白细胞介素1 白细胞介素6 肿瘤坏死因子α 

分 类 号：R692[医药卫生—泌尿科学]