| 摘要: |
| 目的:观察他克莫司(TAC)治疗儿童难治性肾病综合征(RNS)的疗效和安全性。方法:48例原发性RNS患儿随机分为TAC组和环磷酰胺(CTX)组各24例,观察并比较两组患儿在治疗过程中各项检查指标的变化情况。结果:CTX组1例患儿因并发症退出研究。47例患儿经过24周的治疗后,TAC组完全缓解15例,部分缓解6例,总有效率87.5%,CTX组完全缓解9例,部分缓解5例,总有效率60.9%,两组比较差异有统计学意义(P<0.05);两组患儿在治疗的相同疗程中,TAC组比CTX组的24 h尿蛋白定量、血白蛋白、总胆固醇改善情况更明显(P<0.05)。不良反应发生率CTX组(25.0%)明显高于TAC组(8.3%)。结论:TAC治疗儿童难治性肾病综合征在治疗早、中期有很好的疗效,无论是起效时间还是治疗效果均优于CTX。 |
| 关键词: 他克莫司 儿童 难治性肾病综合征 钙调磷酸酶抑制剂 血药浓度 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2017.10.006 |
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| 基金项目: |
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| Tacrolimus Combined with Glucocorticoid in the Treatment of Children with Refractory Nephrotic Syndrome |
| Zhang Jingxiu1 , Zhang Liming2 |
| (1.Linyi Centre Hospital, Shandong Linyi 276400, China; 2.Weifang People's Hospital,
Shandong Weifang 261000, China) |
| Abstract: |
| Objective: To observe the efficacy and safety of tacrolimus (TAC) in the treatment of children with refractory nephrotic syndrome (RNS). Methods: Forty-eight cases of primary RNS were randomly divided into TAC group and cyclophosphamide (CTX) group, 24 children in each group. The changes of the indexes in the two groups were observed and compared. Results: After 24 weeks of treatment, in the TAC group, 15 cases were complete remission, 6 cases were partial remission, the total effective rate was 87郾.5%. In the CTX group, 9 cases were complete remission, 5 cases partial remission, the total effective rate was 60.9%, and the total effective rate of the two groups was statistically significant(P<0.05). In the same course of treatment, the 24 hours urine protein, serum albumin, total cholesterol in the TAC group were better than those of CTX group (P<0.05). Adverse reactions in group CTX (25.0%) were significantly higher than those in group TAC (8.3%). Conclusion: TAC in the treatment of RNS in children has good effect in the early and middle stages of treatment郾It is superior to CTX in both the onset time and the treatment effect. |
| Key words: tacrolimus children refractory nephrotic syndrome calcium regulated phosphatase inhibitor plasma drug concentration |
