甲泼尼龙、他克莫司治疗原发性肾病综合征

Methylprednisolone and Tacrolimus in the Treatment of Primary Nephrotic Syndrome

目的探讨甲泼尼龙联合他克莫司治疗老年原发性肾病综合征效果。方法研究时段为2015年3月—2018年3月年,研究对象为我院收治的72例老年原发性肾病综合征患者,随机分为对照组36例、观察组36例,对照组给予甲泼尼龙单纯治疗,观察组在此基础上联合他克莫司治疗,观察对比两组患者治疗效果。结果观察组治疗总有效率为77.78%,明显高于对照组50.56%(P <0.05);治疗前1周,就24 h尿蛋白、血清白蛋白水平而言,两组患者不存在明显差异,对比无统计学意义(P> 0.05),治疗12周后,两组24 h尿蛋白水平降低,血清白蛋白水平升高,且观察组降幅、增幅均大于对照组(P <0.05);就不良反应发生率而言,观察组8.34%略高于对照组5.56%,但差异不存在统计学差异(P> 0.05)。结论在老年原发性肾病综合征治疗中,甲泼尼龙与他克莫司联合治疗效果理想,推荐推广。

Objective To investigate the effect of methylprednisolone combined with tacrolimus on elderly patients with primary nephrotic syndrome.Methods The study period was from March 2015 to March 2018.The study subjects were 72 elderly patients with primary nephrotic syndrome admitted to our hospital.They were randomly divided into the control group(36 cases)and the observation group(36 cases).The control group received methylprednisolone alone.On the basis of this,the observation group combined with tacrolimus to observe and compare the therapeutic effects of the two groups.Results The total effective rate of the observation group was 77.78%,which was significantly higher than that of the control group(50.56%)(P<0.05).There was no significant difference between the two groups in terms of 24 h urine protein and serum albumin level 1 week before treatment.There was no statistical significance(P >0.05).After 12 weeks of treatment,the 24 h urinary protein level and serum albumin level were increased in the two groups,and the decrease and increase in the observation group were greater than those in the control group(P<0.05);The incidence of adverse reactions was observed.For the observation group,8.34%was slightly higher than the control group of 5.56%,but there was no statistical difference(P >0.05).Conclusion In the treatment of senile primary nephrotic syndrome,the combination of methylprednisolone and tacrolimus is effective and recommended.