他克莫司联合环磷酰胺治疗中重度狼疮肾炎的疗效分析  

Efficacy analysis of tacrolimus combined with cyclophosphamide in the treatment of moderate-to-severe lupus nephritis

作　　者：丁菱[1] 何善智[1] 王明霞[1] 邹婵娟[1] 王敏[1] DING Ling;HE Shan-zhi;WANG Ming-xia(Zhongshan Municipal People's Hospital,Zhongshan 528403,China)

机构地区：[1]中山市人民医院,528403

出　　处：《中国实用医药》2023年第2期28-31,共4页China Practical Medicine

摘　　要：目的探究他克莫司联合环磷酰胺治疗中重度狼疮肾炎的疗效。方法40例中重度狼疮肾炎患者,采用随机数字表法分为对照组及实验组,每组20例。对照组单用环磷酰胺治疗,实验组采用他克莫司联合环磷酰胺治疗。比较两组临床疗效、治疗前后肾功能相关指标[24 h尿蛋白定量(24h UP)、血肌酐(SCr)、血清白蛋白(ALB)、尿素氮(BUN)]水平及用药后不良反应发生率。结果实验组治疗总有效率100.00%显著高于对照组的80.00%,差异有统计学意义(P<0.05)。治疗后,两组患者24h UP、BUN、SCr水平均低于本组治疗前,ALB水平高于本组治疗前,且实验组患者24h UP(0.75±0.16)g/24h、BUN(4.07±0.45)mmol/L、SCr(56.89±5.13)μmol/L显著低于对照组的(1.07±0.34)g/24h、(6.16±0.65)mmol/L、(74.98±5.14)μmol/L,ALB(37.29±3.13)g/L显著高于对照组的(32.98±4.14)g/L,差异具有统计学意义(P<0.05)。实验组患者不良反应发生率为10.00%,与对照组的5.00%比较差异无统计学意义(P>0.05)。结论在中重度狼疮肾炎临床用药方案中,联合使用他克莫司与环磷酰胺的疗效优于单用环磷酰胺,且对患者肾功能改善起到促进作用,同时不会明显增加用药后不良反应,值得应用与推广。Objective To investigate the efficacy of tacrolimus combined with cyclophosphamide in the treatment of moderate-to-severe lupus nephritis.Methods A total of 40 patients with moderate-to-severe lupus nephritis were divided into control group and experimental group according to random numerical table,with 20 cases in each group.The control group was treated with cyclophosphamide alone,and the experimental group was treated with tacrolimus and cyclophosphamide.Both groups were compared in terms of clinical efficacy,renal function-related indexes[24h urinary protein quantification(24h UP),serum creatinine(SCr),serum albumin(ALB),blood urea nitrogen(BUN)]levels before and after treatment and the incidence of adverse reactions after drug administration.Results The total effective rate of treatment in the experimental group was 100.00%,which was significantly higher than 80.00%in the control group,and the difference was statistically significant(P<0.05).After treatment,the 24h UP,BUN and SCr levels of patients in both groups were lower than those before treatment in this group,and ALB levels were higher than those before treatment in this group;the 24 h UP(0.75±0.16)g/24h,BUN(4.07±0.45)mmol/L,and SCr(56.89±5.13)μmol/L of patients in the experimental group were significantly lower than(1.07±0.34)g/24h,(6.16±0.65)mmol/L,and(74.98±5.14)μmol/L in the control group;the ALB(37.29±3.13)g/L in the experimental group was significantly higher than(32.98±4.14)g/L in the control group;the differences were statistically significant(P<0.05).The incidence of adverse reactions in patients in the experimental group was 10.00%,and the difference was not statistically significant when compared with 5.00%in the control group(P>0.05).Conclusion In the clinical medication scheme of moderate-to-severe lupus nephritis,the combined use of tacrolimus and cyclophosphoramide is better than cyclophosphamide alone,and can promote the improvement of renal function without significantly increasing the adverse reactions,which is worth applica

关 键 词：狼疮肾炎 他克莫司 环磷酰胺 疗效 肾功能 不良反应 

分 类 号：R593.242[医药卫生—内科学]