摘要
目的针对难治性肾病综合征患者实施他克莫司与糖皮质激素联合治疗产生的诊治效果及安全性展开分析研究。方法随机选择2019年1月—2021年8月期间90例因难治性肾病综合征在该院肾内科接受治疗的患者作为研究对象,应用单双号分组法将其均分为对照组、研究组,每组45例。对照组接受环磷酰胺与糖皮质激素联合治疗;研究组接受他克莫司与糖皮质激素联合治疗,针对两组治疗效果对比分析。结果研究组临床总疗效97.78%高于对照组,差异有统计学意义(χ^(2)=4.444,P<0.05);治疗后研究组24 h尿蛋白(0.67±0.48)g、血肌酐(65.11±10.87)mol/L、尿素氮(5.63±1.48)mmol/L均低于对照组,差异有统计学意义(t=6.827、4.279、3.604,P<0.05);治疗后研究组高密度脂蛋白水平(1.40±0.41)mmol/L高于对照组,低密度脂蛋白(2.40±0.58)mmol/L、总胆固醇(3.63±0.89)mmol/L、三酰甘油水平(2.49±0.77)mmol/L均低于对照组,差异有统计学意义(t=4.372、13.069、8.485、7.257,P<0.05);研究组不良反应发生率4.44%显著低于对照组,差异有统计学意义(χ^(2)=5.074,P<0.05)。结论采用他克莫司与糖皮质激素联合治疗难治性肾病综合征患者的临床疗效突出,其不良反应发生率较低,安全性相对较高,因此更加适合普及推广使用。
Objective To analyze the efficacy and safety of combined treatment of tacrolimus and glucocorticoids in patients with refractory nephrotic syndrome.Methods A total of 90 patients who were admitted to the Nephrology Department of the hospital for refractory nephrotic syndrome from January 2019 to August 2021 were randomly selected as the research subjects.They were divided into the control group and the study group by the odd-even number grouping method,with 45 cases in each group.The control group received cyclophosphamide and glucocorticoid combined therapy,while the study group received tacrolimus combined with glucocorticoid therapy,and the therapeutic effects of the two groups were compared and analyzed.Results The total clinical efficacy of the study group was 97.78%,higher than that of the control group,the difference was statistically significant(χ^(2)=4.444,P<0.05).The urinary protein(0.67±0.48)g,serum creatinine(65.11±10.87)mol/L and blood urea nitrogen(5.63±1.48)mmol/L in the study group were lower than those in the control group at 24 h after treatment,the difference was statistically significant(t=6.827,4.279,3.604,P<0.05).After treatment,the level of high-density lipoprotein in the study group was(1.40±0.41)mmol/L higher than that in the control group,and the level of low-density lipoprotein(2.40±0.58)mmol/L,total cholesterol(3.63±0.89)mmol/L,and triglyceride(2.49±0.77)mmol/L were lower than those in the control group,the difference was statistically significant(t=4.372,13.069,8.485,7.257,P<0.05).The incidence of adverse reactions in the study group was 4.44%,which was significantly lower than that in the control group,the difference was statistically significant(χ^(2)=5.074,P<0.05).Conclusion The clinical efficacy of tacrolimus combined with glucocorticoids in the treatment of patients with refractory nephrotic syndrome is outstanding,the incidence of adverse reactions is low,and the safety is relatively high,so it is more suitable for popularization and use.
作者
吕俊
LYU Jun(Department of Nephrology,Changshu Hospital Affiliated to Soochow University(Changshu First People's Hospital),Changshu,Jiangsu Province,215500 China)
出处
《中外医疗》
2022年第14期112-115,190,共5页
China & Foreign Medical Treatment
