他克莫司联合泼泥松片与恩替卡韦治疗合并乙型肝炎病毒感染的膜性肾小球肾炎疗效观察

Efficacy of Tacrolimus Combined with Prednisone Tablets and Enecavir in the Treatment of Membranous Glomerulonephritis Complicated with HBV Infection

目的观察他克莫司联合泼尼松片与恩替卡伟治疗合并乙型肝炎病毒(HBV)感染的膜性肾小球肾炎的疗效。方法选择2015年3月—2018年3月南阳市第二人民医院收治的50例合并HBV感染的膜性肾小球肾炎患者,按照随机数字表法将患者分为对照组与观察组(各25例)。对照组患者采用泼尼松片[0.05mg(/kg·d)]和恩替卡伟(0.5mg/d)治疗,观察组患者采用他克莫司[0.05mg(/kg·d)]联合泼尼松片[0.05mg(/kg·d)]与恩替卡伟(0.5mg/d)治疗,比较两组患者的治疗疗效,治疗前后的尿蛋白定量、白蛋白、谷丙转氨酶、谷草转氨酶水平。结果观察组患者的治疗效果明显高于对照组,差异有统计学意义(P<0.05);治疗前,两组患者各指标比较无明显差异(P>0.05);治疗后,两组患者尿蛋白定量、谷丙转氨酶、谷草转氨酶显著降低,白蛋白明显升高(P<0.05);且观察组尿蛋白定量、谷丙转氨酶、谷草转氨酶均显著低于对照组,白蛋白明显高于对照组(P<0.05)。结论他克莫司联合泼尼松片与恩替卡伟治疗合并HBV感染的膜性肾小球肾炎效果更明显,能够保护肾脏功能,控制HBV的复制。

Objective To observe the efficacy of tacrolimus combined with prednisone tablets and enecavir in the treatment of membranous glomerulonephritis complicated with HBV infection. Methods 50 patients with membranous glomerulonephritis compli cated with HBV infection from March,2015 to March,2018were randomly divided into two groups:control group(n=25)and obser vation group(n=25). The patients in the control group were treated with prednisone tablets[0.05 mg(/ kg·d)]and enecavir(0.5 mg/ d),and the patients in the observation group were treated with tacrolimus[0.05 mg(/ kg·d)]combined with prednisone tablets[0.05 mg(/ kg·d)]and enecavir(0.5 mg/d)were used to compare the therapeutic efficacy,urinary protein quantity,albumin,glutamic pyruvic transaminase and glutamic oxaloacetic transaminase levels before and after treatment. Results The therapeutic effect of the pa tients in the observation group was significantly higher than that in the control group(P<0.05),but there was no significant differ ence between the two groups before treatment(P>0.05). After treatment,the urine protein quantity,glutamic pyruvic transaminase, glutamic oxaloacetic transaminase in the two groups decreased significantly and albumin increased significantly(P<0.05). The urine protein quantity,glutamic pyruvic transaminase,alanine aminotransferase in the observation group were significantly higher than the control group(P<0.05). Glutamic-oxaloacetic transaminase was significantly higher in the observation group than that in the control group(P<0.05). Conclusion Tacrolimus combined with prednisone tablets and enecavir are more effective in treating membranous glomerulonephritis complicated with HBV infection,which can protect renal function and control the replication of HBV.