引用本文:黄小红,刘嘉粦,张煜华.他克莫司与环磷酰胺治疗儿童激素耐药型肾病综合征的临床疗效比较[J].中国临床新医学,2019,12(11):1230-1233.
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他克莫司与环磷酰胺治疗儿童激素耐药型肾病综合征的临床疗效比较
黄小红,刘嘉粦,张煜华
514031 广东,梅州市人民医院儿内二科
摘要:
[摘要] 目的 比较他克莫司(TAC)与环磷酰胺(CTX)治疗儿童激素耐药型肾病综合征的临床疗效。方法 选择2012-01~2018-01梅州市人民医院收治的40例激素耐药型肾病综合征为研究对象,按药物使用的不同分为治疗组和对照组各20例,治疗组使用糖皮质激素+TAC治疗,对照组使用糖皮质激素+CTX治疗。比较两组患者尿蛋白、下肢水肿、血白蛋白、胆固醇及药物不良反应(肾毒性、骨髓抑制及胃肠道紊乱等)。结果 治疗6个月时,治疗组患者尿蛋白、血白蛋白及下肢水肿指标优于对照组患者,差异有统计学意义(P<0.05);两组胆固醇水平比较差异无统计学意义(P>0.05);治疗组治疗6个月时的临床疗效优于对照组,总药物不良反应发生率低于对照组(P<0.05);治疗组与对照组治疗12个月时各观察指标差异无统计学意义(P>0.05)。结论 TAC治疗儿童激素耐药型肾病综合征近期临床疗效略优于CTX,药物不良反应相对较小。
关键词:  他克莫司  环磷酰胺  肾病综合征
DOI:10.3969/j.issn.1674-3806.2019.11.21
分类号:R 725.8
基金项目:
Comparison of the clinical effects of tacrolimus and cyclophosphamide on treatment of children with steroid-resistant nephrotic syndrome
HUANG Xiao-hong, LIU Jia-lin, ZHANG Yu-hua
The Second Department of Pediatric Internal Medicine, the People′s Hospital of Meizhou City, Guangdong 514031, China
Abstract:
[Abstract] Objective To compare the clinical effects of tacrolimus(TAC) and cyclophosphamide(CTX) on treatment of children with steroid-resistant nephrotic syndrome. Methods Forty children with steroid-resistant nephrotic syndrome were enrolled in the People′s Hospital of Meizhou City between January 2012 and January 2018 and were divided into treatment group(n=20) and control group(n=20) according to different medications. The treatment group received glucocorticoid plus TAC, while the control group was treated with glucocorticoid plus CTX. The levels of urinary protein, albumin and cholesterol, edama of lower extremity and the adverse drug reactions including renal toxicity, bone marrow suppression and gastrointestinal disorders were compared between the two groups. Results There was significant difference in urinary protein, albumin and edama of lower extremity between the treatment group and in the control group after six months treatment(P<0.05), however, there was no significant difference in the cholesterol between the two groups(P>0.05). The therapeutic effects in the treatment group was better than that in the control group and the incidence of adverse drug reactions in the treatment group was significantly lower than that in the control group 6 months after treatment(P<0.05). There were no significant differences in the observation indexes between the two groups 12 months after treatment(P>0.05). Conclusion The short-term clinical effects of TAC are slightly better than those of CTX on treatment of children with steroid-resistant nephrotic syndrome and TAC has less adverse drug reactions.
Key words:  Tacrolimus  Cyclophosphamide  Nephrotic syndrome