环孢素A联合西罗莫司对激素抵抗型肾病综合征患者的血清脂谱和肾功能的影响  

Effect of cyclosporine combined with sirolimus A on serum lipid profile and renal function in patients with hormone-resistant nephrotic syndrome

作　　者：杨冰 YANG Bing(Department of Internal Medicine,Zhengzhou Bus Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州公交医院内科,郑州450000

出　　处：《医药论坛杂志》2025年第4期429-433,437,共6页Journal of Medical Forum

摘　　要：目的探究环孢素A与西罗莫司联合治疗对激素抵抗型肾病综合征(nephrotic syndrome,NS)患者的血清脂谱和肾功能的影响。方法选择2022年5月—2023年8月在郑州公交医院肾脏内科住院治疗的激素抵抗型NS患者为研究对象,共90例,随机数字表法分为两组,对照组口服西罗莫司,观察组口服西罗莫司及环孢素A,观察临床疗效,进一步对比两组炎症因子、血清脂谱、肾功能及不良反应结果。结果相比对照组77.78%有效率,观察组93.22%的有效率更高,差异具有统计学意义,P<0.05;观察组治疗后三酰甘油(triacylglyceride,TG)、总胆固醇(total cholesterol,TC)及低密度脂蛋白胆固醇(Low-Density Lipoprotein Cholesterol,LDL-C)水平更低,分别为(1.31±0.27)mmol/L、(4.46±0.51)mmol/L和(2.21±0.45)mmol/L,高密度脂蛋白胆固醇(High-Den⁃sity Lipoprotein Cholesterol,HDL-C)则更高,为(1.92±0.61)mmol/L,差异具有统计学意义,P<0.05;经过治疗后,观察组的血肌酐(Serum creatinine,Scr)、24 h尿蛋白及尿素氮(blood Urea Nitrogen,BUN)水平更低,为(0.51±0.15)g、(65.32±5.21)μmol/L和(6.12±1.23)mmol/L,肌酐清除率(creatinine clearance rate,Ccr)显著更高,为(65.82±6.82)mL/min,差异具有统计学意义,P<0.05;治疗后与对照组相比,观察组的白介素-6(In⁃terleukin-6,IL-6)和超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)水平更低,分别为(4.15±0.42)ng/L和(19.83±2.65)ng/L,白介素-4(Interleukin-4,IL-4)水平更高,为(43.52±6.27)ng/L,差异具有统计学意义,P<0.05;观察组发生不良反应发生率为4.44%,比对照组16.78%更低,差异具有统计学意义,P<0.05。结论环孢素A联合西罗莫司对治疗激素抵抗型NS,能够提高临床疗效,改善血清脂谱水平,对肾功能的改善有促进作用,缓解炎症反应的同时提高治疗安全性。Objective To investigate the effect of sirolimus combined with cyclosporine A on serum lipid profile and re⁃nal function in patients with steroid-resistant nephrotic syndrome.Methods A total of 90 patients with hormone-re⁃sistant NS who were hospitalized in the Department of Nephrology of our hospital from May 2022 to August 2023 were se⁃lected as the study objects.They were evenly divided by lottery.The control group was given oral sirolimus,and the ob⁃servation group was treated with sirolimus and cyclosporine A,to observe the clinical efficacy,and further compare the serum lipid profile,renal function,inflammatory factors and adverse reactions of the two groups.Results Compared with the control group(77.78%),the observation group(93.22%)had a higher effective rate(P<0.05).The levels of triacylglyceride,total cholesterol and low density lipoprotein cholesterol in the observation group were lower after treat⁃ment[(1.31±0.27)mmol/L,(4.46±0.51)mmol/L and(2.21±0.45)mmol/L,respectively],and high density lipoprotein cholesterol was higher[(1.92±0.61)mmol/L],and the difference was significant(P<0.05);after treatment,24 h urinary protein,serum creatinine and blood urea nitrogen levels were lower in the observation group[(0.51±0.15)g,(65.32±5.21)μmol/L and(6.12±1.23)mmol/L],creatinine clearance rate Ccr was significantly higher[(65.82±6.82)mL/min],and the difference was significant(P<0.05);after treatment,the observation group had lower levels of hypersensitive C-reactive protein and interleukin-6 than the control group[(4.15±0.42)ng/L and(19.83±2.65)ng/L,respectively],the interleukin-4 level was higher[(43.52±6.27)ng/L],and the difference was significant(P<0.05).The probability of adverse events in the observation group was 4.44%,which was lower than 16.78%in the control group,and the difference was significant(P<0.05).Conclusion Sirolimus combined with cyclosporine A in the treatment of hormone-resistant NS can improve clinical efficacy,improve serum lipid profile,promote the improvement of renal

关 键 词：环孢素A 西罗莫司 激素抵抗型 肾病综合征 血清脂谱 肾功能 

分 类 号：R580[医药卫生—内分泌]