对比他克莫司与环磷酰胺经静脉冲击治疗小儿激素依赖型肾病综合征/频复发型肾病综合征的临床疗效

Comparison of clinical efficacy and safety of FK506 versus CTX in the treatment of children with SDNS/FRNS

目的:对比他克莫司与环磷酰胺经静脉冲击治疗小儿激素依赖型肾病综合征/频复发型肾病综合征的临床疗效及安全性.方法:选取我院90例小儿激素依赖型肾病综合征/频复发型肾病综合征,分为对照组行环磷酰胺静脉冲击治疗与研究组行他克莫司治疗,两组各45例.对比两组激素剂量、复发频率、血清胆固醇、血清白蛋白、尿蛋白等指标及并发症发生情况.结果:治疗后对照组激素剂量[(13.85±5.26)mg/d]低于治疗前[(36.84 ±10.42)mg/d],复发频率[(1.14±0.75)次/年]低于治疗前[(4.96±2.64)次/年],研究组激素剂量[(15.96±4.86) mg/d]低于治疗前[(39.02±12.75)mg/d],复发频率[(1.32±0.85)次/年]低于治疗前[(5.32±2.17)次/年],两组治疗后激素剂量与复发频率对比均无明显差异;两组治疗后血清胆固醇、血清白蛋白、尿蛋白等指标均优于治疗前,而同时间点组间比较均无明显差异;治疗后研究组并发症发生率(8.89%)明显低于对照组(26.67%).结论:他克莫司与环磷酰胺静脉冲击治疗小儿激素依赖型肾病综合征/频复发型肾病综合征的临床疗效较为类似,但他克莫司治疗更能够降低并发症发生率,安全性更高,其应用价值更高.

Objective To compare the clinical efficacy and safety of tacrolimus and intravenous cyclophosphamide in children with steroid-dependent nephrotic syndrome / frequently relapsing nephrotic syndrome. Methods 90 children with steroiddependent nephrotic syndrome / frequently relapsing nephrotic syndrome were selected in our hospital and divided into the control group received intravenous cyclophosphamide treatment and the study group underwent tacrolimus treatment, with 45 cases in each. The hormone dose, relapse frequency, serum cholesterol, serum albumin, urine protein, incidence of complications and other indicators were compared between the two groups. Results After treatment, the hormone dosage in the control group [(13.85 ± 5.26) mg/d ] was lower than that before treatment [(36.84 ± 10.42) mg/d ] and the frequency of relapse [(1.14 ± 0.75) times / year ] was also lower than that before treatment〔(4.96 ± 2.64) times/ year ];the hormone dosage in the study group [(15.96 ± 4.86 mg/d ] was lower than that before treatment [(39.02 ± 12.75) mg/d ] and the frequency of relapse [(1.32 ± 0.85) times/ year ] was also lower than that before treatment [(5.32 ± 2.17) times/ year ], but there were no significant difference in hormone dosage and relapse frequency between the two groups after treatment;after treatment, the cholesterol, serum albumin, urine protein and other indicators of the two groups were better than before treatment, while there were no significant difference in those indicators between the two groups;after treatment, the incidence rate of complications in the study group (8.89%) was significantly lower than that in the control group (26.67%). Conclusion Tacrolimus and intravenous cyclophosphamide in children with steroid-dependent nephrotic syndrome / frequency relapsing nephrotic syndrome have similar clinical efficacy, but tacrolimus has lower rate of complications and higher safety, with higher application value.