他克莫司治疗难治性肾病综合征的新进展  

Progress of treatment for refractory nephrotic syndrome with tacrolimus

作　　者：王化英 周广宇[1] 王艺璇[1] 郭莹[1] 尹敏[1] 吴晨[1] Wang Huaying;Zhou Guangyu;Wang Yixuan;Guo Ying;Yin Min;Wu Chen(Department of Nephrology,China-Japan Union Hospital of Jilin University,Changchun 130033,Jilin Province,China)

机构地区：[1]吉林大学中日联谊医院肾内科,长春130033

出　　处：《中华肾病研究电子杂志》2018年第4期186-189,共4页Chinese Journal of Kidney Disease Investigation（Electronic Edition）

基　　金：吉林省科技厅自然基金项目(20160101059JC);国家自然科学基金面上项目(81370810);横向课题项目(2017YX301)

摘　　要：难治性肾病综合征约占原发性肾病综合征的30%～50%,包括激素依赖型、激素抵抗型和频复发型,具有病程长、易复发等特点。若得不到合理治疗可导致疾病难以缓解,并可能出现严重并发症,甚至进展为不可逆性慢性肾衰竭,极大影响患者生存质量,并威胁生命。目前,难治性肾病综合征患者多加用免疫抑制剂治疗,以糖皮质激素联合烷化剂较为经典,但其潜在的性腺毒性、骨髓抑制及致癌等不良反应限制了临床应用。近年,国内外应用新型免疫抑制剂他克莫司在治疗难治性肾病综合征中取得了较好疗效,本文就他克莫司治疗难治性肾病综合征的疗效及安全性方面的新进展做一综述。Refractory nephrotic syndrome accounts for about 30%-50% of primary nephrotic syndrome,including steroid-dependent nephrotic syndrome,steroid-resistant nephrotic syndrome,and frequent relapse nephrotic syndrome,with characteristics of long durations and easy relapses.If the state of disease cannot be controlled with proper treatment,it might progress to chronic renal failure even with serious complications which greatly affects the patients' quality of life and might be life-threatening.Although immunosuppressive therapies such as corticosteroids plus alkylating agents have been adopted as classic regimens,the potential gonadal toxicity,bone marrow suppression,and carcinogenic adverse effects limit their clinical applications.In recent years,tacrolimus,a novel immunosuppressive agent,has shown relatively good effects in the treatment of refractory nephrotic syndrome at home and abroad.This article presented the new progress in the efficacy and safety of tacrolimus for the treatment of refractory nephrotic syndrome.

关 键 词：他克莫司 难治性肾病综合征 糖皮质激素 疗效 

分 类 号：R692[医药卫生—泌尿科学]