小剂量糖皮质激素联合他克莫司治疗特发性膜性肾病临床疗效与血清抗PLA2R抗体的关系  

Relationship between serum anti-PLA2R antibody and clinical efficacy of low-dose glucocorticoid combined with tacrolimus in the treatment of idiopathic membranous nephropathy

作　　者：邱波[1] 袁良东[1] 李洋[1] 张士奇[1] 梁卫东[1] Qiu Bo;Yuan Liangdong;Li Yang;Zhang Shiqi;Liang Weidong(Department of Nephrology,Affiliated Hospital of Jining Medical College,Jining 272000,China)

机构地区：[1]济宁医学院附属医院肾内科,山东济宁272000

出　　处：《实用药物与临床》2022年第12期1090-1093,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨小剂量糖皮质激素与他克莫司联合治疗特发性膜性肾病的临床疗效与血清抗PLA2R抗体的相关性。方法纳入2018年2月至2021年10月济宁医学院附属医院肾内科经肾活检病理诊断为特发性膜性肾病的80例患者,分为血清抗PLA2R抗体阳性组48例和阴性组32例,给予醋酸泼尼松片0.5 mg/(kg·d),联合他克莫司0.05~0.1 mg/(kg·d)治疗,分别于治疗3个月、6个月后评估两组的总体缓解率(完全缓解率+部分缓解率)。结果治疗3个月后,阳性组、阴性组的总体缓解率分别为31.3%、34.4%,差异无统计学意义(P>0.05)。治疗6个月后,阴性组总体缓解率高于阳性组(75.0%vs.62.5%),差异有统计学意义(P<0.05)。结论与血清抗PLA2R抗体阳性患者相比,他克莫司联合小剂量糖皮质激素在治疗血清抗PLA2R抗体阴性的特发性膜性肾病患者中具有较高的总体缓解率。Objective To investigate the correlation between serum anti-PLA2R antibody and low-dose glucocorticoid combined with tacrolimus in the treatment of idiopathic membranous nephropathy.Methods A total of 80 patients with idiopathic membranous nephropathy diagnosed by renal biopsy from February 2018 to October 2021 in the Department of Nephrology in our hospital were enrolled.Forty-eight patients in serum anti-PLA2R antibody positive group and 32 patients in serum anti-PLA2R antibody negative group were treated with prednisone acetate tablet 0.5 mg/(kg·d)combined with tacrolimus 0.05~0.1 mg/(kg·d).The overall response rate(complete response rate plus partial response rate)of the two groups were evaluated after 3 and 6 months of treatment,respectively.Results After 3 months of treatment,the overall remission rate of the two groups was 31.3%in positive group and 34.4%in negative group,with no significant difference(P>0.05).After 6 months of treatment,the overall remission rate of serum anti-PLA2R antibody negative group was 75%,which was significantly higher than that of serum anti-PLA2R antibody positive group(62.5%,P<0.05).Conclusion Compared with patients with positive serum anti-PLA2R antibody,tacrolimus combined with low-dose glucocorticoids has a higher overall response rate in patients with idiopathic membranous nephropathy whose serum anti-PLA2R antibody is negative.

关 键 词：特发性膜性肾病 抗磷脂酶A2受体抗体 他克莫司 

分 类 号：R692[医药卫生—泌尿科学]