他克莫司治疗老年激素抵抗型肾病综合征的临床疗效

Clinical Efficacy of Tacrolimus in Elderly Patients With Steroid-Resistant Nephrotic Syndrome

目的研究激素抵抗型肾病综合征老年患者采用他克莫司治疗的临床效果。方法临床纳入92例我院2014年2月至2015年2月期间收治的激素抵抗型肾病综合征老年患者,所有患者按随机数字表法分为两组各46例。其中46例患者采用环磷酰胺治疗作为对照组,另46例患者采用他克莫司治疗作为观察组。结果观察组、对照组总有效率分别为91.30%、76.09%,观察组明显较高(P<0.05)。治疗前两组患者TC、TG、Scr、FPG、尿蛋白以及白蛋白水平无统计学差异(P>0.05);治疗后除FPG两组无差异外,观察组TC、TG、Scr、尿蛋白以及白蛋白水平均优于对照组(P<0.05)。两组患者不良反应包括恶心呕吐、肌酐升高以及低血压等,观察组、对照组发生率分别为4.35%、21.74%,观察组明显较低(P<0.05)。结论他克莫司对激素抵抗型肾病综合征老年患者治疗效果显著,有效改善肾功能和生化指标,不良反应少,值得临床应用及推广。

Objective To study the clinical efficacy of tacrolimus in elderly patients with steroid-resistant nephrotic syn- drome.Methods 92 elderly patients with steroid-resistant nephrotic syndrome treated from February 2014 to February 2015 in our hospital were selected.The subjects were randomly divided into two groups,46 cases each group.The control group took cyelophos- phamide; the observation group took tacrolimus.Results The total effective rate of observation group（91.30%）was higher than that of control group （76.09%） （P〈0.05） ; before treatment, the level of TC, TG, Scr, FPG, urine protein and albumin for two groups was not significantly different （P〉O.05）; after treatment, the level of TC ,TG, Scr, urine protein and albumin for observation group was better than that of control group（P〈0.05 ）; the rate of adverse reactions like nausea, vomiting, increasing creatinine and hypotension for observation group（4.35%）was lower than that of control group（21.74%）（P〈0.05 ）.Conclusion Tacrolimus has an obvious effect in elderly patients with steroid-resistant nephrotic syndrome, can improve their renal function and biochemical index and reduce the adverse event rate.h is worthy of clinical application and promotion.