摘要
目的 分析难治性肾病综合征(RNS)不同分型患者环孢霉素(Cs A)谷浓度/剂量(C0/D)比值及血液学指标差异,探究RNS患者环孢霉素C0/D比值与血液学指标的相关性。方法 收集58例于2018年1月-2020年6月在浙江省某医院使用Cs A治疗的RNS患者临床资料,共分成5组:膜性肾病(MN)组、狼疮性肾炎(LN)组、系膜增生型肾小球肾炎(MPGN)组、局灶节段性肾小球硬化症(FSGS)组、微小病变肾病(MCD)组。采用Kruskal-Wallis H检验和MannWhitney U检验比较组间临床资料差异;采用Spearman相关分析研究RNS患者C0/D比值与年龄及血液学指标的相关性。结果 LN组和MPGN组肌酐(CREA)水平高于MN组,LN组、MPGN组和MCD组尿素(UREA)水平高于MN组,MCD组直接胆红素(DBi)水平高于MN、LN和MPGN组,FSGS组DBi水平高于MN组(P <0. 05),其余指标差异无统计学意义(P>0. 05);环孢霉素C0/D比值与患者年龄、CREA、UREA水平成正相关(r值分别为0. 444、0. 505和0. 538,P值分别为0. 001、0. 000和0. 000),与血红蛋白(Hb)呈负相关(r值为-0. 279,P值为0. 037),与其他指标无明显相关性。结论 不同RNS分型患者之间CREA、UREA、DBi之间存在差异;RNS患者环孢霉素C0/D比值与年龄、CREA、UREA水平呈正相关,与Hb呈负相关,临床可以根据不同患者年龄和CREA、UREA、Hb差异合理调整给药剂量,控制环孢霉素谷浓度。
Objective To analyze the valley concentration/dose(Co/D)ratio of cyclosporin(CSA)and hematological indexes in patients with different types of refractory nephrotic syndrome(RNS),and to explore the correlation between cyclosporine Co/D ratio and hematological indexes in patients with refractory nephrotic syndrome(RNS).Methods Clinical data of 58 patients with RNS treated with CsA in a hospital in Zhejiang Province from January 2018 to June 2020 were collected.They were divided into five groups:membranous nephropathy(MN),lupus nephritis(LN),mesangial proliferative glomerulonephritis.(MPGN),focal segmental glomerulosclerosis(FSGS)and minimal change disease(MCD).Kruskal Wallis H test and Mann Whitney U test were used to compare the difference of clinical data between groups;Spearman correlation analysis was used to study the correlation between C_(0)/D ratio and age and hematological indexes in patients with RNS.Results The levels of creatinine(CREA)in.LN group and MPGN group were higher than those in Mn gi-oup;urea(UREA)level in LN group,MPGN group and MCD group was higher than that in Mn group;direct bilirubin(DBi)level in MCD group was higher than that in MN,LN and MPGN groups;DBI level in FSGS group was higher than that in MN group(P<0.05);there was no statistical significance on the difference of other indexes(P>0.05);Cyclosporine C_(0)/D ratio was positively correlated with age,CREA and UREA levels(r=0.444,r=0.505,r=0.538,0.001,0.000,0.000),and negatively correlated with hemoglobin(Hb)(r=-0.279,P=0.037),but not with other indicators.Conclusion There were differences in CREA,UREA and DBI among patients with different types of RNS;the ratio of cyclosporin C_(0)/D was positively correlated with age,CREA and UREA levels,but negatively correlated with Hb.The dosage of cyclosporine could be adjusted according to the age of patients and the difference of CREA,UREA and Hb to control the valley concentration of cyclosporin.
作者
沈利洪
于海涛
SHEN Li-hong;YU Hai-tao(Clinical Laboratory,Jinhua Hospital Affiliated to School of Medicine,Zhejiang University,Jinhua,Zhejiang 321000,China;不详)
出处
《中国卫生检验杂志》
CAS
2021年第18期2229-2233,共5页
Chinese Journal of Health Laboratory Technology
基金
浙江省基础公益研究计划项目(LGC19H200005)。
