他克莫司治疗特发性膜性肾病的临床观察

发布时间：2018-06-28 20:23

本文选题：特发性膜性肾病 + 免疫抑制剂　；参考：《吉林大学》2014年硕士论文

【摘要】：目的：通过与经典的激素联合环磷酰胺（cyclophoshhamide，CTX）相比较，观察激素联合他克莫司（tacrolimus，TAC）在短期内治疗特发性膜性肾病(idiopathic membranous nephropathy,IMN)的疗效及安全性。方法：选取我院肾病科2008年10月至2013年9月经肾穿刺活检术后明确诊断为特发性膜性肾病患者，临床表现为肾病综合征，接受免疫抑制治疗，且治疗后6个月内随访资料完整，共计20例，分为他克莫司组（A组）和环磷酰胺组（B组）。观察两组患者治疗前后的血清白蛋白和24小时尿蛋白定量变化，以及药物带来的不良反应。结果：治疗6个月后，他克莫司组缓解率84.6%（11/13），环磷酰胺组缓解率71.4%（5/7），差异无统计学意义（P0.05）。与治疗前相比较，两组患者治疗后血清白蛋白明显上升（P0.05），24小时尿蛋白定量明显下降（P0.05）。两组同一时间相互比较，他克莫司组血清白蛋白和24小时尿蛋白定量较环磷酰胺组明显改善（P0.05）。治疗6个月内，两组患者未见严重不良反应。结论：激素联合他克莫司治疗治疗特发性膜性肾病有效，，且起效快，短期效果可能优于激素联合环磷酰胺。
[Abstract]:Objective:
By comparing with the classic hormone combined with cyclophosphamide (cyclophoshhamide, CTX), the efficacy and safety of hormone combined with tacrolimus (TAC) in the short-term treatment of idiopathic membranous nephropathy (idiopathic membranous nephropathy, IMN) was observed.
Method:
The diagnosis of idiopathic membranous nephropathy in the Department of nephropathy of our hospital from October 2008 to 2013, 9 menstruation, was diagnosed as idiopathic membranous nephropathy. The clinical manifestations were nephrotic syndrome and received immunosuppressive therapy, and the follow-up data were complete within 6 months after treatment. A total of 20 cases were divided into the tacrolimus group (group A) and the cyclophosphamide group (group B). The treatment of the treatment of two groups of patients was observed. Changes in serum albumin and 24 hours urine protein before and after treatment, as well as adverse drug reactions.
Result:
After 6 months of treatment, the remission rate of the tacrolimus group was 84.6% (11/13) and the remission rate of cyclophosphamide group was 71.4% (5/7). The difference was not statistically significant (P0.05). Compared with the pre treatment, the serum albumin increased significantly in the two groups (P0.05), and the urine protein decreased significantly (P0.05) in 24 hours (P0.05). The two groups were compared with each other at the same time in the tacrolimus group. Protein and 24 hours urine protein were significantly improved compared with cyclophosphamide group (P0.05). No serious adverse reactions occurred in the two groups during 6 months of treatment.
Conclusion:
Hormone combined with tacrolimus is effective and effective in the treatment of idiopathic membranous nephropathy. The short-term effect may be better than that of glucocorticoid combined with cyclophosphamide.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R692

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