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激素联合不同免疫抑制剂治疗难治性肾病综合征
黄基立,王港,许武红,宋丹,谭任缝
0
(中国科学院大学深圳医院)
摘要:
目的 探讨激素联合不同免疫抑制剂治疗难治性肾病综合征(NS)的临床疗效。方法 选取我院2016年3月~2019年2月的70例成人难治性NS为研究对象,根据患者治疗方式不同分为观察组30例和对照组40例。两组均给予甲泼尼龙片口服,观察组另给予吗替麦考酚酯(MMF)治疗,对照组另给予他克莫司胶囊治疗,对比两组尿蛋白、血清指标、治疗有效率及不良反应。结果 治疗后3个月,与对照组相比较,观察组尿蛋白(1.2±0.4) g/d vs (2.8±0.5) g/d、血清白蛋白(42.6±2.7) g/L vs (33.6±2.5) g/L差异明显(P<0.05);与对照组相比较,观察组血清SCr(67.34±9.15) μmol/L vs (78.63±8.21) μmol/L、BUN(5.68±0.62) mmol/L vs (7.16±0.82) mmol/L、〖JP〗TGF-β1(31.24±3.76) μg/L vs (41.68±4.27) μg/L、IL-8(53.21±6.72) μg/L vs (72.15±8.46) μg/L明显较低(P<0.05)。观察组治疗有效率(96.7%)明显高于对照组(77.5%)(P<0.05)。观察组不良反应发生率(6.7%)低于对照组(10.0%),但差异不明显(P>0.05)。结论 激素联合吗替麦考酚酯在成人难治性NS中能够改善患者尿蛋白、血清蛋白指标,明显降低患者血清SCr、BUN、TGF-β1及IL-8,治疗效果较好,副作用发生率较低,可在临床推广应用。
关键词:  吗替麦考酚酯  激素治疗  成人  难治性肾病综合征  免疫抑制剂
DOI:
基金项目:
Effect analysis of steroid therapy combined with different immunosuppressive agents in treatment of refractory nephrotic syndrome
HUANG Jili,WANG Gang,XU Wuhong,SONG Dan,TAN Renfeng
(Shenzhen Hospital, University of Chinese Academy of Sciences)
Abstract:
Objective To investigate the effect of steroid therapy combined with different immunosuppressive agentsin the treatment of refractory nephrotic syndrome. Methods 70 patients of adult refractory nephrotic syndrome in our hospital from March 2016 to February 2019. 30 cases were divided into the observation group and 40 cases in the control group. Two groups were orally administered with methylprednisolone tablets. The observation group was given MMF treatment, and the control group was given FK506 capsules. The urine protein, serum index, treatment efficiency and adverse reactions were compared between the two groups. Results Three months after the treatment, compared with the control group, the difference of urine protein (1.2±0.4) g/D vs (2.8±0.5) g/D, serum albumin (42.6±2.7) g/L vs (33.6±2.5) g/L was significant (P<0.05). IL 8 (53.21±6.72) μg/L vs (72.15±8.46) μ g/L was significantly lower (P<0.05). The effective rate of treatment in the observation group (96.7%) was significantly higher than that in the control group (775%) (P<0.05). The incidence of adverse reactions in the observation group (6.7%) was lower than that in the control group (10.0%), but the difference was not significant (P>0.05). Conclusion Based on hormone therapy, mycophenolate mofetil ester can improve the urinary protein and serum protein index in adult refractory NS, and significantly reduce the serum SCR, bun, TGF-β1 and IL-8.
Key words:  Mycophenolate mofetil  Hormone therapy  Adult  Refractory nephrotic syndrome  Immunosuppressive agent

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