他克莫司缓释剂对肾病综合征患者肾功能和免疫功能的影响

Effects of tacrolimus on renal function and immune function in patients with nephrotic syndrome

目的观察他克莫司缓释剂对肾病综合征(NS)患者肾功能、免疫功能及高迁移率族蛋白-1(HMGB-1)等的影响。方法入选我院肾内科就诊的108例NS患者,随机分为对照组54例和试验组54例,所有患者均采取常规治疗。试验组患者加用他克莫司进行治疗,根据患者体重按0.15 mg·kg^-1服用,分2次口服。2组患者均连续治疗4周。比较2组患者治疗前后的免疫指标、肾功能、内皮素-1(ET-1)、HMGB-1和核转录因子-κB(NF-κB)水平。结果治疗后,试验组的CD3^+、CD4^+和CD4^+/CD8^+水平分别为(68.17±2.57)%,(48.02±2.24)%,1.95±0.25,对照组分别为(61.26±2.73)%,(37.61±2.63)%,1.65±0.24,差异均有统计学意义(均P<0.05)。治疗后,试验组血清尿素氮(BUN)、血肌酸酐(Scr)、ET-1、HMGB-1和NF-κB水平分别为(8.15±1.58)mmol·L^-1,(123.82±12.35)μmol·L^-1,(107.91±10.21)pg·m L^-1,(16.18±5.58)ng·L^-1,(763.87±162.34)ng·L^-1,对照组分别为(10.27±1.43)mmol·L^-1,(162.68±19.69)μmol·L^-1,(171.25±11.23)pg·m L^-1,(27.17±6.49)ng·L^-1,(1352.61±219.39)ng·L^-1,差异均有统计学意义(均P<0.05)。结论他克莫司缓释剂对NS患者具有良好的治疗效果,可减轻患者炎症反应,明显改善患者免疫功能及肾功能,减轻NS的损害。

Objective To investigate the effects of tacrolimus on renal function,immune function and high mobility group protein-1(HMGB-1)in patients with nephrotic syndrome(NS).Methods A total of108 patients with NS in department of nephrology in our hospital were randomly divided into control group and treatment group,54 cases in each group.All patients were treated with routine therapy,and the treatment group was added with tacrolimus 0.15 mg·kg^-1,according to patient’s weight,divided into two times,oral.Two groups were treated for 4 weeks.The immune indexes,renal function,the levels of endothelin-1(ET-1),HMGB-1 and nuclear factor-κB(NF-κB)in two groups before and after treatment were compared.Results After treatment,the levels of CD3^+,CD4^+ and CD4^+/CD8^+ in treatment group were(68.17±2.57)%,(48.02±2.24)%,1.95±0.25,all had significant difference with those in control group,which were(61.26±2.73)%,(37.61±2.63)%,1.65±0.24(all P<0.05).After treatment,the levels of blood urea nitrogen(BUN),creatinine(Scr),ET-1,HMGB-1 and NF-κB in treatment group were(8.15±1.58)mmol·L^-1,(123.82±12.35)μmol·L^-1,(107.91±10.21)pg·m L^-1,(16.18±5.58)ng·L^-1,(763.87±162.34)ng·L^-1,all had significant difference with those in control group,which were(10.27±1.43)mmol·L^-1,(162.68±19.69)μmol·L^-1,(171.25±11.23)pg·m L^-1,(27.17±6.49)ng·L^-1,(1352.61±219.39)ng·L^-1(all P<0.05).Conclusion Tacrolimus sustained-release agent has a good therapeutic effect on patients with NS.It can alleviate inflammation,improve immune function and renal function,and reduce the damage of NS.