强的松联合他克莫司治疗狼疮性肾炎患者的效果分析  

Effect Analysis of Prednisone Combined With Tacrolimus in the Treatment of Patients With Lupus Nephritis

作　　者：刘芸芳[1] 唐盛[1] 韦俏宇[1] LIU Yunfang;TANG Sheng;WEI Qiaoyu(Department of Nephrology,People's Hospital of Guangxi Zhuang Autonomous Region,Nanning Guangxi 530021,China)

机构地区：[1]广西壮族自治区人民医院肾内科,广西南宁530021

出　　处：《中国继续医学教育》2021年第20期163-166,共4页China Continuing Medical Education

摘　　要：目的探讨强的松联合他克莫司治疗狼疮性肾炎患者效果。方法选取2017年7月—2019年7月期间于本院收治的活动性狼疮性肾炎患者共62例,采用随机数表法分为他克莫司组(n=31例)和环磷酰胺组(n=31例),他克莫司组予他克莫司联合强的松治疗,环磷酰胺组予环磷酰胺联合强的松治疗。比较两组的临床疗效、24 h尿蛋白及血肌酐、系统性红斑狼疮活动指数(SLEDAI)评分以及不良反应的发生情况。结果治疗后他克莫司组总有效率显著高于环磷酰胺组(P<0.05);治疗后两组患者24 h尿蛋白及血肌酐较治疗前均明显下降(P<0.05),且他克莫司组下降程度更显著(P<0.05);治疗后两组SLEDAI评分较治疗前均下降(P<0.05),他克莫司组下降程度更显著(P<0.05);他克莫司组不良反应发生率低于环磷酰胺组(6.45%vs.25.81%,P<0.05)。结论强的松联合他克莫司治疗狼疮性肾炎患者疗效显著,可显著改善患者肾功能,减少狼疮活动,不良反应较少。Objective To investigate the effect of prednisone combined with tacrolimus in the treatment of patients with lupus nephritis.Methods From July 2017 to July 2019,a total of 62 patients with active lupus nephritis who were treated in our hospital were selected and divided into two groups by random number table:the clirolimus group(n=31 cases)and the cyclophosphamide group(n=31 cases).The tacrolimus group was treated with tacrolimus combined with prednisone, and the cyclophosphamide group was treated with cyclophosphamide combined with prednisone. The clinical efficacy, 24 h urinary protein, serum creatinine, systemic lupus erythematosus activity index (SLEDAI) score and the occurrence of adverse reactions were compared between the two groups. Results After treatment, the total effective rate of tacrolimus group was significantly higher than that of cyclophosphamide group (P<0.05);after treatment, the 24 h urinary protein and serum creatinine of both groups were significantly decreased compared with that before treatment (P<0.05), and the degree of decrease was more significant in tacrolimus group (P<0.05);after treatment, the SLEDAI scores of both groups were decreased compared with that before treatment (P<0.05), and the degree of decrease was more significant in tacrolimus group.(P<0.05);the incidence of adverse reactions in tacrolimus group was lower than that in cyclophosphamide group (6.45% vs 25.81%, P<0.05).Conclusion Prednisone combined with tacrolimus is effective in the treatment of patients with lupus nephritis, which can significantly improve renal function, reduce lupus activity and have fewer adverse reactions.

关 键 词：他克莫司 环磷酰胺 狼疮性肾炎 强的松 肾功能 狼疮活动 

分 类 号：R692[医药卫生—泌尿科学]