他克莫司联合糖皮质激素治疗难治性肾病综合征的效果观察  

Efficacy of tacrolimus combined with glucocorticoids on refractory nephrotic syndrome

作　　者：崔东锋[1] 徐亚沛[1] 邹燕[1] Cui Dongfeng;Xu Yapei;Zou Yan(Department of Nephrology and Rheumatology,Zhengzhou Third People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省郑州市第三人民医院肾病风湿科,郑州450000

出　　处：《中国实用医刊》2022年第5期92-95,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨他克莫司(FK506)联合糖皮质激素(GC)治疗难治性肾病综合征(RNS)的疗效。方法抽取2017年1月至2021年1月郑州市第三人民医院收治的86例RNS患者作为研究对象,按随机数字表法将其分为FK506组和环磷酰胺(CTX)组,每组43例。CTX组采用CTX联合GC治疗,FK506组采用FK506联合GC治疗,比较两组疗效,治疗前后糖脂代谢、肾功能、肾损伤标志物指标及不良反应发生率。结果 FK506组总有效率(95.35%,41/43)高于CTX组(74.42%,32/43),P<0.05。治疗后,FK506组总胆固醇、三酰甘油水平,24 h尿蛋白定量、血肌酐水平及视黄醇结合蛋白、肾损伤分子-1水平均低于对照组(P均<0.05)。FK506组不良反应发生率(2.33%,1/43)低于CTX组(18.60%,8/43),P<0.05。结论 FK506联合GC应用于RNS治疗中可提升疗效,改善患者糖脂代谢,有利于降低肾损伤并改善肾功能,具有较高的用药安全性。Objective To investigate the efficacy of tacrolimus(FK506)combined with glucocorticoids(GC)in the treatment of refractory nephrotic syndrome(RNS).Methods Eighty-six RNS patients treated in Zhengzhou Third People’s Hospital from January 2017 to January 2021 were taken as the research object,and they were divided into FK506 group and Cyclophosphamide(CTX)group according to the random number table method,with 43 cases in each group.CTX group was treated with CTX combined with GC,and FK506 group was treated with FK506 combined with GC.Efficacy,glucolipid metabolism,renal function,markers of renal injury before and after treatment,and incidence of adverse reactions were compared between the two groups.Results The total effective rate in FK506 group was 95.35%(41/43),which was higher than the 74.42%(32/43)in CTX group(P<0.05).After treatment,the levels of total cholesterol,triacylglycerol,24-hour urinary protein,serum creatinine,retinol binding protein and renal injury molecule-1 in FK506 group were lower than those in the control group(all P<0.05).The incidence of adverse reactions in FK506 group was 2.33%(1/43),which was lower than the 18.60%(8/43)in CTX group(P<0.05).Conclusions FK506 combined with GC in the treatment of RNS can improve the efficacy,improve the glucose and lipid metabolism of patients Moreover,it is conducive to reduce renal injury and improve renal function,and has high drug safety.

关 键 词：肾病综合征 他克莫司 糖皮质激素 肾损伤标志物 

分 类 号：R692[医药卫生—泌尿科学]