难治性肾病综合征采用他克莫司联合糖皮质激素治疗的效果分析  

Analysis of the Effect of Tacrolimus Combined with Glucocorticoid in the Treatment of Refractory Nephrotic Syndrome

作　　者：唐婧霞 邹建华[1] TANG Jingxia;ZOU Jianhua(Department of Nephrology,Changshu First People's Hospital,Changshu,Jiangsu Province,215500 China)

机构地区：[1]常熟市第一人民医院肾内科,江苏常熟215500

出　　处：《中外医疗》2022年第8期5-8,共4页China & Foreign Medical Treatment

基　　金：2020年常熟市卫生健康委员会科技计划项目(csws202015)。

摘　　要：目的研究他克莫司联合糖皮质激素治疗难治性肾病综合征的效果。方法随机选取该院2019年3月—2021年4月收治的80例难治性肾病综合征患者为研究对象,采用计算机产生随机数抽样方法随机分为对照组和实践组,各40例。对照组患者开展环磷酰胺+糖皮质激素治疗,实践组患者实施他克莫司+糖皮质激素治疗。对比分析两组临床疗效、临床指标、不良反应发生率。结果治疗前,两组患者24 h尿蛋白、BUN、Scr、UA、ALB、TG、ALT、AST指标对比,差异无统计学意义(P>0.05);治疗后,实践组TG(1.28±0.12)mmol/L、AST(15.38±3.49)μmol/L低于对照组,ALB(38.45±6.72)g/L、ALT(22.57±3.49)μmol/L高于对照组,24 h尿蛋白、BUN、Scr、UA指标均低于对照组,差异有统计学意义(P<0.05)。实践组临床治疗总有效率(95.00%)高于对照组,差异有统计学意义(χ^(2)=6.274,P=0.012)。实践组不良反应发生率(7.50%)明显低于对照组,差异有统计学意义(χ^(2)=5.541,P=0.018)。结论在难治性肾病综合征的治疗中,采用他克莫司+糖皮质激素治疗在改善患者免疫抑制活性、提高患者肝功能方面效果显著,且用药后安全性较高,适合加以推广。Objective To study the effect of tacrolimus combined with glucocorticoid in the treatment of refractory nephrotic syndrome.Methods 80 patients with refractory nephrotic syndrome treated in the hospital from March 2019 to April 2021 were conveniently selected as the research object.They were randomly divided into control group and practice group by computer-generated random number sampling method,with 40 cases in each group.Patients in the control group were treated with cyclophosphamide+glucocorticoid,while patients in the practice group were treated with tacrolimus+glucocorticoid.The clinical efficacy,clinical indexes and incidence of adverse reactions were compared and analyzed between the two groups.Results Before treatment,there was no statistically significant difference in 24 h urinary protein,BUN,Scr,UA,ALB,TG,ALT and AST between the two groups(P>0.05).After treatment,the indexes of TG(1.28±0.12)mmol/L and AST(15.38±3.49)μmol/L in the practice group were lower than those in the control group,while those of ALB(38.45±6.72)g/L and ALT(22.57±3.49)μmol/L were higher than control group,and the indexes of 24 h urinary protein,BUN,Scr and UA were lower than those in the control group,the difference was statistically significant(P<0.05).The total effective rate of clinical treatment in the practice group(95.00%)was higher than that in the control group,the difference was statistically significant(χ^(2)=6.274,P=0.012).The incidence of adverse reactions in the practice group(7.50%)was significantly lower than that in the control group,the difference was statistically significant(χ^(2)=5.541,P=0.018).Conclusion In the treatment of refractory nephrotic syndrome,the use of tacrolimus+glucocorticoid therapy is effective in improving the immunosuppressive activity and liver function of patients,and it is safe and suitable for promotion.

关 键 词：他克莫司 糖皮质激素 难治性肾病综合征 临床疗效 临床指标 

分 类 号：R692[医药卫生—泌尿科学]