研究他克莫司联合吗替麦考酚酯对特发性膜性肾病患者氧化应激反应及肾功能保护的影响

Effects of Tacrolimus Combined with Mycophenolate Mofetil on Oxidative Stress and Renal Function Protection in Patients with Idiopathic Membranous Nephropathy

研究他克莫司联合吗替麦考酚酯对特发性膜性肾病患者氧化应激反应及肾功能保护的影响,为临床联合用药提供依据。收集该院2014年11月~2018年1月救治的100例特发性膜性肾病患者视为研究对象,按照随机数字表方式进行分组,两组均给予强的松片,对照组同时给予他克莫司口服治疗,研究组在对照组基础上加用吗替麦考酚酯口服治疗。比较两组治疗前后氧化应激指标、免疫功能指标、炎症反应指标、肾功能指标、不良反应及治疗有效率情况。治疗后,研究组丙二醛(MDA)明显低于对照组,超氧化物歧化酶(SOD)、一氧化氮(NO)明显高于对照组,差异有统计学意义(P<0.05);研究组血清转化生长因子-β(TGF-β)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平均低于对照组,差异显著(P<0.05);CD4^+、CD4^+/CD8^+、免疫球蛋白G(Ig G)均明显高于对照组,CD8^+明显低于对照组,差异有统计学意义(P<0.05);研究组血清肌酸酐(SCr)、尿素氮(BUN)、24 h尿蛋白定量、胱抑素C(Cys C)均明显低于对照组,有统计学差异(P<0.05);研究组治疗后总缓解率为94.00%,而对照组为80.00%,两者比较差异有统计学意义(P<0.05);不良反应发生率对比无统计学意义(P>0.05)。他克莫司联合吗替麦考酚酯较单用他克莫司治疗特发性膜性肾病的临床疗效更加确切,更有利于抑制氧化应激反应,降低炎症反应,改善机体免疫功能及肾功能。

To study the effects of tacrolimus combined with mycophenolate mofetil on oxidative stress and renal function protection in patients with idiopathic membranous nephropathy,and provide evidence for clinical combination therapy,100 cases of idiopathic membranous nephropathy treated by the hospital from November 2014 to January 2018 were collected as the study objects,and they were divided into two groups according to the random number table.Both groups were given prednisone tablets,while the control group was given tacrolimus oral treatment,and the study group was given metoclopramide oral treatment on the basis of the control group.The indexes of oxidative stress,immune function,inflammatory response,renal function,adverse reactions and therapeutic effectiveness were compared before and after treatment.After treatment,the MDA of the study group was significantly lower than that of the control group,and the superoxide dismutase(SOD)and nitric oxide(NO)were significantly higher than the control group,the difference was statistically significant(P<0.05);The levels of serum transforming growth factor-β(TGF-β),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)in the group were lower than those in the control group,and the difference was significant(P<0.05);CD4^+,CD4^+/CD8^+and immunoglobulin G(Ig G)were significantly higher than the control group,CD8^+was significantly lower than the control group,the difference was statistically significant(P<0.05);the study group serum creatinine(SCr),urea nitrogen(BUN),24 h urine protein quantitation and Cystatin C(Cys C)were significantly lower than the control group(P<0.05).The total effective rate was 94.00%in the study group and 80.00%in the control group,the difference between the two was statistically significant(P<0.05).The incidence of adverse reactions was not statistically significant(P>0.05).The clinical efficacy of tacrolimus combined with mycophenolate mofetil compared with tacrolimus in the treatment of idiopathic membranous nephropathy is more precise,more conducive to inhibition of oxidative stress.It can reduce inflammatory response,improve immune function and kidney functional.