他克莫司联合糖皮质激素在难治性肾病综合征患者中的疗效分析

Efficacy Analysis of Tacrolimus Combined with Glucocorticoids in Patients with Refractory Nephrotic Syndrome

目的探讨他克莫司联合糖皮质激素在难治性肾病综合征(Refractory Nephrotic Syndrome,RNS)患者中的应用价值。方法方便选取2018年1月—2023年10月六盘水市人民医院收治的76例RNS患者为研究对象,采用随机数表法分为两组,各38例。对照组采用环磷酰胺+泼尼松治疗,观察组采用他克莫司+泼尼松治疗,比较两组肾功能、血脂指标、临床疗效及不良反应发生情况。结果观察组24 h尿蛋白定量、肌酐水平分别为(0.93±0.28)g、(85.56±15.78)μmol/L,低于对照组的(1.06±0.25)g、(94.71±17.22)μmol/L,差异有统计学意义(t=2.135、2.415,P均<0.05)。观察组总胆固醇、三酰甘油水平低于对照组,治疗总有效率高于对照组,差异有统计学意义(P均<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论在RNS患者联合用药期间,他克莫司+泼尼松的疗效显著,能够改善患者的肾功能指标与血脂指标,且用药安全性良好。

Objective To explore the application value of tacrolimus combined with glucocorticoids in patients with refractory nephrotic syndrome(RNS).Methods A total of 76 RNS patients admitted to Liupanshui People's Hospital from January 2018 to October 2023 were conveniently selected as the study objects,and they were divided into two groups with 38 cases each by random number table method.The control group was treated with cyclophosphamide+prednisone,and the observation group was treated with toperlimus+prednisone.The renal function,lipid index,clinical efficacy and occurrence of adverse reactions were compared between the two groups.Results The 24 h urinary protein and creatinine levels in the observation group were(0.93±0.28)g and(85.56±15.78)μmol/L,respectively,which were lower than those in the control group(1.06±0.25)g and(94.71±17.22)μmol/L,and the differences were statistically significant(t=2.135,2.415,both P<0.05).The levels of total cholesterol and triacylglycerol in observation group were lower than those in control group,and the total effective rate of treatment was higher than that in control group,and the differences were statistically significant(all P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion During the period of combined medication in RNS patients,the efficacy of tacrolimus+prednisone is remarkable,which can improve the renal function index and lipid index of patients,and the safety of medication is good.