他克莫司联合糖皮质激素治疗难治性肾病综合征的临床疗效

Clinical effect of tacrolimus combined with glucocorticoid for refractory nephrotic syndrome

目的探讨他克莫司联合糖皮质激素治疗难治性肾病综合征的临床疗效。方法选取永州市中心医院2017年12月—2018年12月收治的难治性肾病综合征患者80例,按照随机分配原则分为对照组与研究组,各40例。对照组予以醋酸泼尼松片联合环孢素片治疗,研究组予以醋酸泼尼松片联合他克莫司胶囊治疗。比较两组治疗前后肾功能指标〔包括尿蛋白、三酰甘油、胆固醇、血清白蛋白、血尿素氮(BUN)、血肌酐、血尿酸(UA)、天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)〕,并观察两组不良反应发生情况。结果治疗前两组尿蛋白、三酰甘油、胆固醇、血清白蛋白、BUN、血肌酐、UA、AST、ALT比较,差异无统计学意义(P>0.05);治疗后研究组尿蛋白、胆固醇、BUN、血肌酐、UA、AST低于对照组,血清白蛋白高于对照组(P<0.05);治疗后两组三酰甘油、ALT比较,差异无统计学意义(P>0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论他克莫司联合糖皮质激素治疗难治性肾病综合征的临床疗效确切,可改善肾功能,且安全性较高。

Objective To explore the clinical effect of tacrolimus combined with glucocorticoid for refractory nephrotic syndrome.Methods A total of 80 cases of patients with refractory nephrotic syndrome were selected from December 2017 to December 2018 in Yongzhou Central Hospital,they were divided into control group and research group according to the principle of random distribution,40 cases in each group.The control group was treated with prednisone acetate tablets combined with cyclosporine tablets,the research group was treated with prednisone acetate tablets combined with tacrolimus capsules.Renal function indexes before and after treatment(including urine protein,triacylglycerol,cholesterol,serum albumin,BUN,creatinine,UA,AST,ALT)were compared between the two groups,and the incidence of adverse reactions were observed.Results Before treatment,there was no significant difference in urine protein,triglyceride,cholesterol,serum albumin,BUN,creatinine,UA,AST and ALT between the two groups(P>0.05);after treatment,the research group of urine protein,cholesterol,BUN,creatinine,UA and AST were lower than control group,and serum albumin was higher than control group(P<0.05).There was no significant difference in triglyceride and ALT between the two groups after treatment(P>0.05).There was no significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion Tacrolimus combined with glucocorticoid have an exact clinical effect for refractory nephrotic syndrome,which can improve renal function,and with high safety.