他克莫司联合小剂量糖皮质激素治疗肾病综合征的临床观察

The clinical observation of Tacrolimus combined with Low dose glucocorticoid in the treatment of Nephritic syndrome

目的分析他克莫司联合小剂量糖皮质激素治疗。肾病综合征（Nephriticsyndrome，NS）的临床治疗指标及疗效的影响。方法选取2013年3月~2015年3月于我院诊断的218例。肾病综合征患者，按照随机数字表法分为2组：对照组（n=109）采用激素、环磷酰胺（cytoxan，CTX）等常规方法治疗，实验组（17=109）采用他克莫司联合小剂量糖皮质激素治疗，比较不同组别的临床治疗指标及疗效的情况。结果治疗前，实验组同对照组相比，24小时尿蛋白和血清白蛋白等指标差异无统计学意义；治疗后，实验组同对照组相比，24小时尿蛋白减少，差异具有统计学意义（P〈0．05），血清白蛋白增加，差异具有统计学意义（P〈0．05）：胆固醇减少，差异具有统计学意义（P〈0．05）：内生肌酐清除率增加，差异具有统计学意义（P〈0．05）；血肌酐减少，差异具有统计学意义（P〈0．05）：治疗后，实验组同对照组相比，在白细胞减少、尿频、尿急、厌食、脱发等不良反应发生率，明显减少（P〈0．05）；治疗后，实验组同对照组相比，总有效率提高（P〈0．05）。结论他克莫司联合小剂量糖皮质激素治疗肾病综合征具有改善临床治疗指标、降低不良反应、提高总有效率的作用。

Objective To analyze the clinical therapeutic index and effect of Tacrolimus combined with Low dose glucocorticoid in the treatment of Nephritic Syndrome （NS）. Methods Two hundred and eighteen cases with NS admitted to our hospital from march 2013 to march 2015 were selected, these cases were randomly divided into two groups： Patients of the control group （n=109） were treated with conventional methods such as the hormone therapy and CTX, patients of the experimental group （n=109） were treated with Taerolimus combined with Low dose glucocorticoid, clinical therapeutic index and effect of both groups were compared. Results Before the treatment, index such as 24 hours urinary protein and serum albumin of the experimental group have no significant difference compared with the control group; After the treatment, 24 hours urinary protein index of the experimental group was significantly lower compared with the control group （P 〈 0.05）, serum albumin index of the experimental group was significantly higher compared with the control group （P 〈 0.05）; Creatinine clearance of the experimmtal group was significantly higher compared with the control group （P 〈 0.05）; Serum creatinine of the experimental group was significantly lower compared with the control group; The incidence rates of leucopenia, urinary frequency, urgency, anorexia, alopecia of the experimental group were significantly power compared with the control group （P 〈 0.05）; The total effective rate of the experimental group was significantly higher compared with the control group （P 〈 0.05）. Conclusions Tacrolimus combined with Low dose glucocorticoid has the function of Improving the clinical therapeutic index, Reducing adverse reactions and improving the total efficiency rates in the treatment of NS.