他克莫司与环磷酰胺对特发性膜性肾病患者疗效及性激素水平影响的比较
发布时间：2018-08-25 19:47
【摘要】：目的比较他克莫司与环磷酰胺对特发性膜性肾病(IMN)患者的疗效及性激素水平的影响。方法选择以肾病综合征为表现的IMN患者46例,分为他克莫司组28例、对照组18例。他克莫司组给予他克莫司胶囊0.05~0.1 mg/(kg·d),每天分2次空腹服用;醋酸泼尼松片起始剂量0.5 mg/(kg·d)晨起口服,1次/d,8周后减量。对照组给予环磷酰胺0.8 g静脉滴注,每2周1次;同时给予醋酸泼尼松片1.0 mg/(kg·d)晨起口服,1次/d,8周后减量。两组均治疗3个月。治疗前、治疗1个月、治疗3个月时,检测两组24 h尿蛋白定量、血浆白蛋白水平;治疗前及治疗3个月时,检测两组性激素中睾酮(T)、雌二醇(E2)、卵泡刺激素(FSH)、黄体生成素(LH)、泌乳素(PRL)、性激素结合球蛋白(SBG)水平。结果与治疗前相比,他克莫司组治疗1个月时24 h尿蛋白定量减少、血清白蛋白水平增高(P均0.05),环磷酰胺组治疗1个月时24 h尿蛋白定量减少(P0.05);两组治疗3个月时24 h尿蛋白定量均减少,血清白蛋白水平均增高(P均0.05)。与环磷酰胺组相比,他克莫司组治疗1、3个月时24 h尿蛋白定量减少,血清白蛋白水平增高(P均0.05)。与治疗前比较,两组治疗3个月时血清E2、T及SBG水平均下降,FSH及LH水平均升高(P均0.05)。治疗3个月时,他克莫司组血清E2、T及SBG水平均高于对照组,FSH水平低于对照组(P均0.05)。他克莫司组不良反应发生率低于对照组(P0.05)。结论与环磷酰胺方案比较,对临床表现为肾病综合征的IMN患者选用他克莫司方案起效更快、效果更好,且对性激素的抑制作用较小。
[Abstract]:Objective to compare the effect of tacrolimus and cyclophosphamide on (IMN) patients with idiopathic membranous nephropathy. Methods 46 IMN patients with nephrotic syndrome were divided into tacrolimus group (n = 28) and control group (n = 18). Tacrolimus group was given tacrolimus capsule 0.05 mg/ (kg d), twice a day, and prednisone acetate tablet was given orally for 8 weeks after 0.5 mg/ (kg d). The control group was given cyclophosphamide 0.8 g intravenously once every 2 weeks, and prednisone acetate tablet was given orally at 1 / d for 8 weeks from 1 mg/ (kg d) in the morning. Both groups were treated for 3 months. Before treatment, 1 month after treatment, 3 months after treatment, the levels of 24 h urinary protein and plasma albumin were measured in both groups, and before and after 3 months of treatment, The levels of testosterone (T), estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), (PRL), sex hormone binding globulin (SBG) in the two groups were measured. Results compared with those before treatment, the urinary protein in tacrolimus group decreased at 24 h after 1 month treatment. The level of serum albumin increased (P 0.05), and the urine protein of 24 h decreased in cyclophosphamide group at 1 month (P0.05), and decreased at 3 months after treatment in both groups (all P 0.05). Compared with cyclophosphamide group, the urinary protein and serum albumin in tacrolimus group decreased at 24 h after 1 month treatment (all P 0.05). Compared with those before treatment, the levels of serum E2T and SBG decreased and the levels of FSH and LH increased at 3 months after treatment in both groups (P < 0. 05). After 3 months of treatment, the serum levels of E2FSH and SBG in tacrolimus group were significantly higher than those in control group (P < 0. 05). The incidence of adverse reactions in tacrolimus group was lower than that in control group (P0.05). Conclusion compared with cyclophosphamide regimen, tacrolimus regimen is more effective and less effective than cyclophosphamide regimen in IMN patients with nephrotic syndrome.
【作者单位】： 郑州大学第二附属医院;新乡医学院第一附属医院;
【基金】：河南省科技发展计划项目(142102310300)
【分类号】：R692
[Abstract]:Objective to compare the effect of tacrolimus and cyclophosphamide on (IMN) patients with idiopathic membranous nephropathy. Methods 46 IMN patients with nephrotic syndrome were divided into tacrolimus group (n = 28) and control group (n = 18). Tacrolimus group was given tacrolimus capsule 0.05 mg/ (kg d), twice a day, and prednisone acetate tablet was given orally for 8 weeks after 0.5 mg/ (kg d). The control group was given cyclophosphamide 0.8 g intravenously once every 2 weeks, and prednisone acetate tablet was given orally at 1 / d for 8 weeks from 1 mg/ (kg d) in the morning. Both groups were treated for 3 months. Before treatment, 1 month after treatment, 3 months after treatment, the levels of 24 h urinary protein and plasma albumin were measured in both groups, and before and after 3 months of treatment, The levels of testosterone (T), estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), (PRL), sex hormone binding globulin (SBG) in the two groups were measured. Results compared with those before treatment, the urinary protein in tacrolimus group decreased at 24 h after 1 month treatment. The level of serum albumin increased (P 0.05), and the urine protein of 24 h decreased in cyclophosphamide group at 1 month (P0.05), and decreased at 3 months after treatment in both groups (all P 0.05). Compared with cyclophosphamide group, the urinary protein and serum albumin in tacrolimus group decreased at 24 h after 1 month treatment (all P 0.05). Compared with those before treatment, the levels of serum E2T and SBG decreased and the levels of FSH and LH increased at 3 months after treatment in both groups (P < 0. 05). After 3 months of treatment, the serum levels of E2FSH and SBG in tacrolimus group were significantly higher than those in control group (P < 0. 05). The incidence of adverse reactions in tacrolimus group was lower than that in control group (P0.05). Conclusion compared with cyclophosphamide regimen, tacrolimus regimen is more effective and less effective than cyclophosphamide regimen in IMN patients with nephrotic syndrome.
【作者单位】： 郑州大学第二附属医院;新乡医学院第一附属医院;
【基金】：河南省科技发展计划项目(142102310300)
【分类号】：R692
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