他克莫司联合甲基强的松龙治疗难治性特发性膜性肾病的效果观察

Effect observation of tacrolimus combined with prednisone in treatment of patients with refractory idiopathic membranous nephropathy

目的观察他克莫司联合甲基强的松龙治疗难治性特发性膜性肾病的临床效果。方法将100例难治性特发性膜性肾病患者随机分为2组,每组50例。对照组给予环磷酰胺联合甲基强的松龙治疗,观察组给予他克莫司联合甲基强的松龙治疗。2组均连续治疗12个月,比较2组临床疗效、血清白蛋白、24 h尿蛋白定量及不良反应发生情况。结果观察组总缓解率高于对照组,差异有统计学意义(P<0.05)。治疗1、3、6、12个月后,观察组血清白蛋白水平均高于对照组,24 h尿蛋白定量均低于对照组,差异有统计学意义(P<0.05)。2组均未发生严重不良反应。结论他克莫司联合甲基强的松龙治疗难治性特发性膜性肾病疗效显著,可提高血清白蛋白水平,降低24 h尿蛋白定量。

Objective To observe the clinical effect of tacrolimus combined with prednisone in the treatment of patients with refractory idiopathic membranous nephropathy.Methods One hundred patients with refractory idiopathic membranous nephropathy were randomly divided into two groups,with 50 cases in each group.The control group was treated with cyclophosphamide and prednisone,while the observation group was treated with tacrolimus and prednisone.Both groups were treated for 12 months.The clinical efficacy,serum albumin,24 h urine protein quantification and occurrence of adverse reactions were compared between two groups.Results The total remission rate of the observation group was significantly higher than that of the control group(P<0.05).After 1 month,3,6 and 12 months of treatment,the serum albumin level of the observation group was significantly higher than that of the control group,and the 24 h urinary protein quantification was significantly lower than that of the control group(P<0.05).No serious adverse reactions occurred in both groups.Conclusion Tacrolimus combined with prednisone is effective in the treatment of patients with refractory idiopathic membranous nephropathy,which can increase the level of serum albumin and reduce 24 h urine protein quantification.