小儿激素耐药型肾病综合征用他克莫司的方案探究  

Study on the Scheme of Comprehensive Requisition of Tacrolimus in Children With Steroid Resistant Nephropathy

作　　者：杨晓晶[1,2,3] YANG Xiaojing(Department of Pediatrics,The First Affiliated Hospital of Xiamen University,Xiamen Fujian 361003,China;Pediatric Key Laboratory of Xiamen,Xiamen Fujian 361003,China;Institute of Pediatrics,School of Medicine,Xiamen University,Xiamen Fujian 361003,China)

机构地区：[1]厦门大学附属第一医院儿科,福建厦门361003 [2]厦门市儿科重点实验室,福建厦门361003 [3]厦门大学医学院儿童医学研究所,福建厦门361003

出　　处：《中国卫生标准管理》2020年第24期95-98,共4页China Health Standard Management

摘　　要：目的探析小儿激素耐药型肾病综合征(steroid resistant nephrotic syndrome,SRNS)他克莫司不同用药方案的疗效。方法选取2016年1月—2019年1月我院儿科诊治的64例SRNS患儿纳入研究中,基于乱数表法分成试验组和对照组,各32例;对照组用糖皮质激素(GC)+他克莫司方案治疗,试验组用GC+他克莫司+小剂量西罗莫司治疗,均治疗6个月,对比治疗前后血清总胆固醇(TC)、血肌酐(Scr)、肾小球滤过率(GFR)、白蛋白(ALB)及24 h尿蛋白的水平,并掌握总缓解率、不良反应率。结果试验组治疗6个月后的TC、Scr、GFR、ALB及24 h尿蛋白均显著优于对照组(P<0.05),治疗前、治疗1个月后均无明显差异(P>0.05)。试验组总缓解率为93.75%,对照组为90.62%,差异无统计学意义(P>0.05)。试验组不良反应发生率为9.38%,显著低于对照组的31.25%(P<0.05)。结论他克莫司三联用药相比二联用药效果更确切,能有效改善患儿肾功能、血尿指标,并可减少不良反应。Objective To study the children’s steroid resistant nephrotic syndrome SRNS)the efficacy of tacrolimus in different drug regimens.Methods From January 2016 to January 2019,64 SRNS children diagnosed and treated in the pediatric department of our hospital were included in the study.Based on random number table method,they were divided into experimental group and control group,32 cases each.Control group with glucocorticoid(GC)+Tacrolimus solution treatment,the experimental group with GC+Tacrolimus+small dose sirolimus treatment.All patients were treated for 6 months.Serum total cholesterol(TC),serum creatinine(Scr),glomerular filtration rate(GFR),albumin(propagated)and 24 h urine protein levels,and grasp the total remission rate,adverse reaction rate before and after treatment were compared.Results TC,Scr,GFR,ALB and urine protein at 24 h after 6 months of treatment in the experimental group were significantly better than those in the control group(P<0.05),and there were no significant differences before and after 1 month of treatment(P>0.05).The total remission rate was 93.75%in the experimental group and 90.62%in the control group,with no statistically significant difference(P>0.05).The incidence of adverse reactions in the experimental group was 9.38%,significantly lower than that in the control group(31.25%),(P<0.05).Conclusion The effect of tacrolimus triple therapy is more accurate than double therapy,which can effectively improve the renal function and hematuria index of children,and reduce adverse reactions.

关 键 词：小儿 激素耐药型 肾病综合征 他克莫司 西罗莫司 

分 类 号：R725[医药卫生—儿科]