特发性膜性肾病患者采用他克莫司与环磷酰胺联合激素治疗的临床效果比较

A Comparison on Clinical Curative Effect of Tacrolimus and Cyclophosphamide in Combination with Hormone on Patients with Idiopathic Membranous Nephropathy

目的：探究分析特发性膜性肾病患者采用他克莫司（TL）联合激素与环磷酰胺（CTX）联合激素治疗的临床效果.方法：随机选取某院在2011年12月~2014年12月期间收治的195例特发性膜性肾病患者为研究对象,并将其分为实验组98例和对照组97例,其中对照组患者给予CTX联合激素治疗,实验组患者给予他克莫司联合激素治疗.治疗6个月后,观察并对比两组患者治疗前后的生化指标变化及临床治疗效果.结果：治疗后实验组患者的生化指标变化均明显优于对照组（P 〈0.05）,两组患者在治疗期间均出现一定的不良反应,其中实验组的不良反应率（11.2%）远远低于对照组（24.7%）,并且实验组患者的临床总缓解率达到了80.6%,而对照组总缓解率为67%,两组患者的缓解率对比差异具有统计学意义（P 〈0.05）.结论：他克莫司联合激素和CTX联合激素治疗特发性膜性肾病均有一定的临床效果,相对于环磷酰胺而言,他克莫司能够较好缓解膜性肾病患者蛋白尿的情况,并且具有更高的安全性和有效性,值得临床推广应用.

Objective:To explore and analyze the clinical effect of tacrolimus(TL)combined hormone and cyclophosphamide(CTX)in combination with hormone on patients with idiopathic membranous nephropathy.Methods:Randomly selected 157 patients with idiopathic membranous nephropathy received in some hospital during the period from December 2011 to December 2014 as the research object,and divide them into experimental group(n=78)and control group(n=79),patients in control group patients received CTX plus hormone,while patients in the treatment group received tacrolimus plus hormone.After six months of treatment,observe and compare the changes in biochemical indexes before and after treatment and clinical therapeutic effect in both groups.Results:After treatment,the changes in biochemical indicators in experimental group were significantly better than that in control group(P<0.05),some adverse reactions occurred to some patients in both group during treatment,and the rate of adverse reactions in experimental group patients(11.2%)was far lower than that in control group(24.7%),and the clinical alleviation rate in the experiment group was up to 80.6%,while the rate was 60.7%in control group,the difference between the two groups in remission rate was statistically significant(P<0.05).Conclusion:Both tacrolimus combined with hormone and CTX plus hormone are somewhat effective to treat patients with idiopathic membranous nephropathy,to compare with cyclophosphamide,tacrolimus can better alleviate the situation of albuminuria of patients with membranous nephropathy,and it is safe and effective,worthy of clinical popularization and application.