摘要
目的研究他克莫司联合吗替麦考酚酯对原发性肾病综合征(PNS)的临床疗效及对患者肾功能及疾病复发的影响。方法抽取2015年2月至2020年2月驻马店市中心医院收治的PNS患者100例,采用随机数字表法分为联合组和对照组,每组50例,对照组患者口服他克莫司胶囊,联合组在对照组的基础上服用吗替麦考酚酯胶囊,治疗3个月后,观察比较两组临床疗效、肾功能指标[血肌酐(SCr)、胱抑素C(Cys-C)、尿素氮(BUN)、24 h尿蛋白定量(24hUPQ)]水平及不良反应发生情况,并随访1年,比较1年内复发率。结果联合组总有效率(86.00%)高于对照组(62.00%,P<0.05);治疗前两组BUN、Cys-C、SCr、24 hUPQ水平比较,差异未见统计学意义(P>0.05);治疗后,两组BUN、Cys-C、SCr、24hUPQ水平低于治疗前(P<0.05),联合组BUN、Cys-C、SCr、24hUPQ水平低于对照组(P<0.05);联合组复发率(8.00%)低于对照组(22.00%,P<0.05);两组总不良反应发生率比较,差异未见统计学意义(P>0.05)。结论他克莫司联合吗替麦考酚酯对PNS疗效确切,能有效改善肾功能,降低治疗后复发率,且安全性好,值得临床推广应用。
Objective To investigate the effect of tacrolimus combined with mycophenolate mofetil on primary nephrotic syndrome(PNS)and its influence on renal function and recurrence of patients.Methods A total of 100 PNS patients in Zhumadian Central Hospital from February 2015 to February 2020 were enrolled,and they were divided into combination group and control group by random number table methods,with 50 cases in each group.The patients in the control group took tacrolimus capsule,the combined group took mycophenolate capsule on the basis of the control group,after 3 months of treatment,the clinical efficacy,renal function indicators such as serum creatinine(SCr),cystatin C(Cys-C),blood urea nitrogen(BUN),24 hours urinary protein quantification(24hUPQ)and adverse reaction rate were compared between groups.The recurrence rate was compared within one year.Results The total efficacy rate of combined group was significantly higher than that of control group(86.00%vs 62.00%,P<0.05);levels of BUN,Cys-C,SCr,and 24hUPQ had no significant difference between groups before treatment(P>0.05);after treatment,the levels of BUN、Cys-C,SCr,24hUPQ in the two groups were significantly lower than those before treatment(P<0.05),and the levels of BUN,Cys-C,SCr,24hUPQ in the combined group were significantly lower than those in the control group(P<0.05);the recurrence rate in combined group was significantly lower than that in control group(8.00%vs.22.00%,P<0.05);there was no significant difference in the incidence rate of adverse reactions between two groups(8.00%vs.4.00%,P>0.05).Conclusions Application of tacrolimus combined with mycophenolate mofetil is an effective and safe way to ameliorate renal function and reduce recurrence rate for PNS patients,which is worthy of clinical promotion.
作者
倪娜
康文静
Ni Na;Kang Wenjing(Department of Nephrology,Zhumadian Central Hospital,Zhumadian 463000,China;Department of Rheumatology,Zhumadian Central Hospital,Zhumadian 463000,China)
出处
《中国实用医刊》
2020年第16期96-99,共4页
Chinese Journal of Practical Medicine
