他克莫司治疗难治性IgA肾病的有效性和安全性

发布时间：2018-10-15 19:48

【摘要】：目的探究他克莫司治疗难治性IgA肾病的有效性和安全性。方法纳入2008年6月至2013年9月第二军医大学长征医院收治、经病理确诊的IgA肾病患者共9例,均经肾素-血管紧张素系统(RAS)阻断剂和激素治疗无效后给予他克莫司治疗。观察患者用药后的缓解情况(完全缓解和部分缓解)及达到缓解所需时间、复发次数、他克莫司给药剂量和药物不良反应。结果他克莫司的起始给药剂量为(1.89±0.33)mg/d。经6个月的他克莫司治疗后,6例患者获得完全缓解、2例部分缓解、1例治疗抵抗,大多数患者在治疗后的前2个月内获得缓解。患者的24h尿蛋白定量下降[(3.05±1.35)g vs(0.85±1.54)g,P0.05],血清白蛋白水平升高[(27.00±8.37)g/L vs(37.33±8.08)g/L,P0.05]。1例患者给予他克莫司治疗后表现为高血压加重,其他患者未见不良反应。8例蛋白尿缓解的患者中,3例出现复发,在调整激素剂量和他克莫司剂量后均得到缓解。结论他克莫司可使难治性IgA肾病患者的蛋白尿症状缓解,且不良反应少。
[Abstract]:Objective to investigate the efficacy and safety of tacrolimus in the treatment of refractory IgA nephropathy. Methods from June 2008 to September 2013, 9 patients with IgA nephropathy were admitted to the long March Hospital of the second military Medical University. All the patients were treated with tacrolimus after the failure of renin-angiotensin system (RAS) blocker and hormone therapy. The remission (complete remission and partial remission), the time needed to achieve remission, the number of relapse, the dosage of tacrolimus and adverse drug reactions were observed. Results the initial dose of tacrolimus was (1.89 卤0.33) mg/d.. After 6 months of tacrolimus treatment, 6 patients had complete remission, 2 patients had partial remission, and 1 patient had therapy resistance. Most of the patients got remission within the first 2 months after treatment. The 24-hour urinary protein decreased quantitatively [(3.05 卤1.35) g vs (, 0.85 卤1.54) g P 0.05], the serum albumin level increased [(27.00 卤8.37) g / L vs (37.33 卤8.08) g / L P 0.05]. Both hormone and tacrolimus doses were adjusted for remission. Conclusion tacrolimus can relieve the symptoms of proteinuria in patients with refractory IgA nephropathy with less adverse reactions.
【作者单位】：第二军医大学长征医院肾内科解放军肾脏病研究所;第二军医大学长征医院急救科;第二军医大学东方肝胆外科医院肾内科;
【分类号】：R692.31

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