他克莫司与达格列净联合用药对IgA肾病患者肾功能和免疫功能的影响分析  

Effects of tacrolimus combined with dapagliflozin on renal and immune function in patients with IgA nephropathy

作　　者：苏小霞[1] Su Xiaoxia(Department of Nephrology,Qinzhou Second People′s Hospital,Guangxi 535000,China)

机构地区：[1]广西壮族自治区钦州市第二人民医院肾内科,535000

出　　处：《山西医药杂志》2025年第2期103-106,共4页Shanxi Medical Journal

摘　　要：目的探讨他克莫司与达格列净联合用药对IgA肾病患者肾功能和免疫功能的影响。方法选择2020年1月至2023年10月在我院诊治的70例IgA肾病患者纳入本研究,根据随机抽签分为2组。所有患者均给予利尿、纠正电解质、降压及饮食指导等常规处理,并口服醋酸波尼松片。同时对照组(35例)给予达格列净治疗,观察组(35例)给予他克莫司与达格列净联合用药治疗。比较2组临床疗效、肾功能指标(血肌酐、尿素氮、24 h尿蛋白)水平、免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))及不良反应。结果临床疗效方面,观察组治疗总有效率更高(P<0.05)。治疗后,观察组患者肾功能指标(血肌酐、尿素氮、24 h尿蛋白)水平比对照组更低(P<0.05);免疫功能指标方面,观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)和对照组相比更高,CD8^(+)更低(P<0.05)。不良反应总发生率方面,观察组(11%)略高于对照组(9%),但二者差异无统计学意义(P>0.05)。结论他克莫司与达格列净联合用药治疗IgA肾病的疗效较高,可促进肾功能恢复,改善机体免疫功能,且安全性良好。Objective To explore the effects of the combination of tacrolimus and dapagliflozin on renal and immune function in patients with IgA nephropathy.Methods A total of 70 IgA nephropathy patients diagnosed and treated in our hospital were included in this study from January 2020 to October 2023 and were randomly divided into two groups.All patients were given routine treatments such as diuresis,electrolyte correction,blood pressure reduction,and dietary guidance,as well as oral administration of prednisone acetate tablets.At the same time,the control group(35 cases)was treated with dapagliflozin,while the observation group(35 cases)was treated with a combination of tacrolimus and dapagliflozin.The clinical efficacy,renal function indicators(blood creatinine,urea nitrogen,24-hour urine protein level),immune function indicators(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),and adverse reactions were compared between the two groups.Results The overall efficacy rate of the observation group surpassed the control group significantly(P<0.05).Following the intervention,markers pertaining to renal function,including blood creatinine,urea nitrogen,and 24-hour urine protein levels,were notably reduced in the observation group compared to the control group(P<0.05).Regarding the indices of immune functionality,there was a marked elevation in the levels of CD3^(+),CD4^(+),and the CD4^(+)/CD8^(+)ratio in the observation group compared to the control group.Conversely,the CD8^(+)levels were significantly lower in the observational group(P<0.05).In terms of the overall frequency of adverse reactions,the observation group exhibited a slightly higher rate(11%)compared to the control group(9%),though this difference did not reach statistical significance(P>0.05).Conclusion The combination of tacrolimus and dapagliflozin has a high therapeutic effect on IgA nephropathy and can promote renal function recovery,improves immune function,and is safe.

关 键 词：肾功能试验 肾小球肾炎 IGA 他克莫司 达格列净 免疫功能 

分 类 号：R692.31[医药卫生—泌尿科学]