他克莫司治疗特发性膜性肾病临床疗效观察

Observation on the clinical effect of tacrolimus in the treatment of idiopathic membranous nephropathy

目的探讨他克莫司治疗特发性膜性肾病(IMN)的有效性及安全性。方法选择2007年1月—2011年1月本院肾内科收治IMN患者41例,随机分为他克莫司组(他克莫司联合糖皮质激素治疗)及CTX组(CTX联合糖皮质激素治疗),观察2组患者治疗前后临床指标及有效率、不良反应情况。结果治疗6个月后,2组患者的24 h尿蛋白定量、三酰甘油、胆固醇水平均较治疗前明显下降(P<0.05),血清白蛋白均较治疗前显著升高(P<0.05),且他克莫司组均明显优于CTX组(P<0.05);他克莫司组治疗6个月后总缓解率明显高于对照组(90.48%与65.00%,P<0.05)。结论他克莫司联合糖皮质激素是治疗IMN的有效方案,具有较好的用药安全性。

Objective To investigate the efficacy and safety of tacrolimus in treatment of idiopathic membranous nephropathy. Methods 41 patients with idiopathic membranous nephropathy （IMN） were randomly divided intotacrolimus group and CTX group . The tacrolimus group was treated with tacrolimus combined with glucocorticoid therapy while CTX group was given CTX combined with glucocorticoid therapy. The clinical indicators and efficiency, adverse reactions were observed before and after treatment. Results After 6 months, the levels of the 24 hour urinary protein, triglycerides, cholesterol in both groups decreased significantly （P 〈 0.05）, the serum albumin level was significantly higher （P 〈 0.05 ）, but the improvement of these indicators in tacrolimus group were significantly better than that in the CTX group （P 〈 0.05）. The overall response rate in the tacrolimus group was significantly higher than that in the CTX group （90.48 % vs 65.00 % ） （P 〈 0.05）. Conclusion Therapy of tacrolimus combined with glucocorticoids is an effective and safe program in the treatment of IMN.