他克莫司联合恩替卡韦治疗乙型肝炎合并肾病综合征患者的效果  

Effects of Tacrolimus combined with Entecavir in treatment of patients with hepatitis B complicated with nephrotic syndrome

作　　者：田晓杰 霍志丹 TIAN Xiaojie;HUO Zhidan(Department of Nephrology of Hua County People’s Hospital,Anyang 456400 Henan,China)

机构地区：[1]滑县人民医院肾病内科,河南安阳456400

出　　处：《中国民康医学》2025年第8期51-54,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察他克莫司联合恩替卡韦治疗乙型肝炎(简称乙肝)合并肾病综合征患者的效果。方法:回顾性分析2021年6月至2023年6月该院收治的82例乙肝合并肾病综合征患者的临床资料,按照治疗方法不同将其分为对照组与研究组各41例。对照组采用恩替卡韦治疗,研究组在对照组基础上联合他克莫司治疗。比较两组临床疗效,治疗前后肝功能指标[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)]、肾功能指标[24 h尿蛋白定量、血清肌酐(Cr)、血尿素氮(BUN)]、炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-22(IL-22)、白细胞介素-17(IL-17)]水平,以及不良反应发生率。结果:研究组治疗总有效率为95.12%(39/41),高于对照组的80.49%(33/41),差异有统计学意义(P<0.05);治疗后,两组ALT、AST水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);治疗4、8周后,两组24 h尿蛋白定量、Cr、BUN水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);治疗后,两组TNF-α、IL-22、IL-17水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:他克莫司联合恩替卡韦治疗乙肝合并肾病综合征患者可提高治疗总有效率,降低肝功能指标、肾功能指标和炎性因子水平,效果优于单纯恩替卡韦治疗。Objective:To observe effects of Tacrolimus combined with Entecavir in treatment of patients with hepatitis B complicated with nephrotic syndrome.Methods:The clinical data of 82 patients with hepatitis B complicated with nephrotic syndrome admitted to this hospital from June 2021 to June 2023 were retrospectively analyzed.According to different treatment methods,they were divided into control group and study group,41 cases in each group.The control group was treated with Entecavir,while the study group was treated with Tacrolimus on the basis of that of the control group.The clinical efficacies,the levels of liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST)],renal function indexes[24 h urine protein quantification,serum creatinine(Cr),blood urea nitrogen(BUN)]and inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-22(IL-22),interleukin-17(IL-17)]levels before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the study group was 95.12%(39/41),which was higher than 80.49%(33/41)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of ALT and AST in the two groups were lower than those before the treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).After 4 and 8 weeks of treatment,the levels of 24 h urine protein,Cr and BUN in the two groups were lower than those before the treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of TNF-α,IL-22 and IL-17 in the two groups were lower than those before the treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two gro

关 键 词：他克莫司 恩替卡韦 肾病综合征 乙型肝炎 肝功能 肾功能 炎性因子 

分 类 号：R692.9[医药卫生—泌尿科学]