他克莫司与环磷酰胺治疗更年期狼疮性肾炎的效果及安全性比较  

Comparison of Efficacy and Safety between Tacrolimus and Cyclophosphamide in Treatment of Patients with Climacteric Lupus Nephritis

作　　者：陈菊[1] 周君[1] 朱永俊[2] 

机构地区：[1]海口市人民医院肾病风湿科,海口570208 [2]海南医学院第一附属医院肾内科,海口570102

出　　处：《解放军医药杂志》2017年第8期90-92,共3页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：海南省自然科学基金项目(20168301)

摘　　要：目的对他克莫司与环磷酰胺用于更年期狼疮性肾炎治疗中的效果和安全性进行比较。方法选取2014年10月—2015年10月海口市人民医院治疗的更年期狼疮性肾炎患者79例,按照治疗方法不同分为观察组40例和对照组39例,在口服泼尼松的基础上,观察组和对照组分别给予他克莫司和环磷酰胺治疗,连续给药12个月。对两组的疗效,不良反应发生率及相关客观指标进行评价及比较。结果观察组治疗0.5、1和1.5年的总有效率均高于对照组(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。治疗后,观察组系统性红斑狼疮疾病活动指数、补体C3、24 h尿蛋白、血肌酐、外周血CD20+、促卵泡激素和黄体生成素水平均低于对照组(P<0.05),雌二醇水平高于对照组(P<0.05)。结论在更年期狼疮性肾炎治疗中应用他克莫司的疗效、安全性及客观指标均显著优于环磷酰胺。Objective To compare efficacy and safety between Tacrolimus and Cyclophosphamide in treatment of patients with climacteric lupus nephritis. Methods A total of 79 patients with climacteric [upus nephritis admitted during October 2014 and October 2015 were divided into observation group （n = 40） and control group （n = 39） according to different treatment methods. On the basis of oral Prednisone, observation group and the control group were given Tacrolimus and Cyclophosphamide treatments respectively, and the time of continuous administration was 12 months. Curative effect, incidence rate of adverse reaction and related objective indexes were evaluated and compared in two groups. Results In observation group, the total effective rates after treatment for 6 months, 1 years and 1 and a half years were significantly higher （P 〈 0. 05 ） , while incidence rate of adverse reactions was significantly lower than those in control group （P 〈 0. 05 ）. After treatment, in observation group, values of activity index of systemic lupus erythematosus disease, complement C3, 24 h urinary protein, serum creatinine, peripheral blood CD20 ^＋ , follicle stimulating hormone （FSH） and luteinizing hormone （LH） levels were significantly lower （ P 〈 0.05 ） , while estradiol level was significantly higher than those in control group （P 〈 0. 05）. Conclusion Efficacy, safety and objective indexes of Tacrolimus in treatment of patients with climacteric lupus nephritis can be significantly better than that with Cyclophosphamide.

关 键 词：他克莫司 环磷酰胺 更年期 狼疮肾炎 治疗效果 

分 类 号：R593.242[医药卫生—内科学]