他克莫司联合小剂量泼尼松治疗难治性肾病综合征的效果

Effect of Tacrolimus combined with Low-Dose Prednisone in Treatment of Refractory Nephrotic Syndrome

目的:分析他克莫司联合小剂量泼尼松治疗难治性肾病综合征(RNS)的效果。方法:选取2019年3月-2021年3月贵州航天医院收治的60例RNS作为研究对象,按随机抽签法分为对照组与观察组,各30例。对照组应用泼尼松与环磷酰胺联合治疗,观察组用小剂量泼尼松与他克莫司联合治疗。比较两组治疗效果、肾功能指标、血脂指标及不良反应发生率。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组的血肌酐、尿素氮、24 h尿蛋白水平均低于对照组,血清白蛋白水平高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组的总胆固醇水平、甘油三酯水平及低密度脂蛋白水平均低于对照组,高密度脂蛋白水平高于对照组,差异有统计学意义(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:应用小剂量泼尼松与他克莫司治疗RNS,不仅能提升疗效,还能改善患者肾功能,降低身体血脂水平,促进患者康复,值得推广并予以应用。

Objective:To analyze the effect of tacrolimus in combination with low dose of prednisone in treatment of refractory nephrotic syndrome(RNS).Methods:A total of 60 RNS patients admitted to Guizhou Aerospace Hospital from March 2019 to March 2021 were selected as the study subjects,and they were divided into control group and observation group by random drawing method,with 30 cases in each group.The control group was treated with prednisone combined with cyclophosphamide,and the observation group was treated with low-dose prednisone combined with tacrolimus.The therapeutic effect,renal function index,blood lipid index and incidence of adverse reactions were compared between the two groups.Results:The total effective rate of treatment in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of serum creatinine,urea nitrogen and 24 h urine protein in the observation group were lower than those in the control group,and the serum albumin level was higher than that in the control group,with statistically significant difference(P<0.05).After treatment,the levels of total cholesterol,triglyceride and low-density lipoprotein in the observation group were lower than those in the control group,and the level of high-density lipoprotein was higher than that in the control group,with statistically significant difference(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The application of low-dose prednisone and tacrolimus in the treatment of RNS can not only improve the efficacy,but also improve the renal function of patients,reduce the level of blood lipids,and promote the recovery of patients,which is worthy of popularization and application.