他克莫司联合糖皮质激素治疗特发性膜性肾病的临床效果观察
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摘要
目的:探讨他克莫司联合糖皮质激素治疗特发性膜性肾病的临床效果观察。方法:本次研究的154名患者,均为2015年3月至2018年3月在我院同期接受治疗的特发性膜性肾病患者,使用随机数字法将患者分为对照组与观察组,对照组患者接受环磷酰胺联合糖皮质激素治疗,观察组患者则接受他克莫司联合糖皮质激素治疗,观察对比两组患者所获得的治疗效果。结果:对比两组患者治疗前后的各项临床指标,观察组患者与对照组患者治疗前各项治疗无明显差异,P>0.05,数据无统计学意义;在接受不同的治疗后,观察组患者的尿蛋白、胆固醇、血肌酐水平低于对照组患者,血清白蛋白、甘油三酯水平高于对照组患者,观察组患者的临床治疗总有效率高于对照组患者,观察组患者的整体治疗效果优于对照组患者,P<0.05,数据差异具有统计学意义。结论:特发性膜性肾病患者接受他克莫司联合糖皮质激素治疗,疗效优于环磷酰胺联合糖皮质激素治疗,有着良好的应用前景,可有效地促进患者疾病的好转,提升临床治疗效果,对于我国探视新型治疗模式,具有十分重要的临床意义以及研究意义。
Objective: To investigate the clinical effect of tacrolimus combined with glucocorticoid in the treatment of idiopathic membranous nephropathy. Methods: 154 patients with idiopathic membranous nephropathy treated in our hospital from March 2015 to March 2018 were divided into control group and observation group by random number method. Patients were treated with cyclophosphamide combined with glucocorticoid,while patients in observation group were treated with tacrolimus combined with glucocorticoid. The therapeutic effects of the two groups were observed and compared. Results: The clinical indexes of the two groups were compared before and after treatment, and the patients in observation group and the patients in control group were treated with tacrolimus combined with glucocorticoid. There was no significant difference before treatment(P>0.05). The levels of urinary protein, cholesterol and serum creatinine in the observation group were lower than those in the control group. The level of triacylglycerol was higher than that of the control group, the total effective rate of clinical treatment in the observation group was higher than that in the control group, and the overall therapeutic effect of the observation group was better than that of the control group(P<0.05).Conclusion: Tacrolimus combined with glucocorticoid is more effective than cyclophosphamide combined with glucocorticoid in the treatment of idiopathic membranous nephropathy. The application prospect can effectively promote the improvement of patients' disease and improve the clinical treatment effect. It has very important clinical and research value for exploring the new treatment mode in our country.
Objective: To investigate the clinical effect of tacrolimus combined with glucocorticoid in the treatment of idiopathic membranous nephropathy. Methods: 154 patients with idiopathic membranous nephropathy treated in our hospital from March 2015 to March 2018 were divided into control group and observation group by random number method. Patients were treated with cyclophosphamide combined with glucocorticoid,while patients in observation group were treated with tacrolimus combined with glucocorticoid. The therapeutic effects of the two groups were observed and compared. Results: The clinical indexes of the two groups were compared before and after treatment, and the patients in observation group and the patients in control group were treated with tacrolimus combined with glucocorticoid. There was no significant difference before treatment(P>0.05). The levels of urinary protein, cholesterol and serum creatinine in the observation group were lower than those in the control group. The level of triacylglycerol was higher than that of the control group, the total effective rate of clinical treatment in the observation group was higher than that in the control group, and the overall therapeutic effect of the observation group was better than that of the control group(P<0.05).Conclusion: Tacrolimus combined with glucocorticoid is more effective than cyclophosphamide combined with glucocorticoid in the treatment of idiopathic membranous nephropathy. The application prospect can effectively promote the improvement of patients' disease and improve the clinical treatment effect. It has very important clinical and research value for exploring the new treatment mode in our country.
引文
[1]计蕾,余慰,钟雪.特发性膜性肾病患者血清抗磷脂酶A2受体抗体与尿中Ig G4检测的临床意义[J].中国免疫学杂志, 2018, 34(7):1050-1053, 1058.
[2]赵秀玲.他克莫司联合加味黄芪赤风汤治疗老年特发性膜性肾病的临床疗效[J].中国农村卫生, 2018,(14):36.
[3]徐平,何雨荻,于泽铭,等.环孢素A和他克莫司治疗特发性膜性肾病的有效性及安全性比较:网状Meta分析[J].中国医学科学院学报, 2018,40(1):41-51.
[4]黄俊,李剑文,梁鸣,等.他克莫司联合激素治疗血清抗PLA2R抗体持续高滴度的难治性特发性膜性肾病[J].实用医学杂志, 2018, 34(8):1355-1359.
[5]梁艳,张小玲,朱清,等.肾上腺皮质激素联合免疫抑制剂治疗膜性肾病的疗效及与血清PLA2R抗体浓度的相关性[J].广东医学, 2017, 38(12):1897-1900.
[6]高世平,王莉,姚恬.雷公藤多苷联合小剂量激素治疗特发性膜性肾病的疗效及其对患者血清ET-Ⅰ水平的影响[J].海南医学, 2017, 28(20):3284-3286.
[7]彭佳楠,陈孟华,田娜,等.PLA2R基因单核苷酸多态性与特发性膜性肾病患者临床特征及疗效的相关性研究[J].宁夏医科大学学报, 2017,39(5):519-524,前插1.
[8]郭艳红,郑丹侠,王悦.特发性膜性肾病相关抗原M型磷脂酶A2受体和1型血小板反应蛋白7A域的研究进展[J].中国综合临床, 2017, 33(3):280-285.
[9]莫文辉.他克莫司(Tacrolimus)治疗有肾病综合征表现的特发性膜性肾病的临床疗效及安全性[J].齐齐哈尔医学院学报, 2016, 37(6):724-725.
[10]丁蓓蓓,朱小春.特发性膜性肾病患者采用他克莫司与环磷酰胺联合激素治疗的临床效果比较[J].数理医药学杂志, 2016, 29(1):11-13.
[11]任桐,杨洪涛.系膜增生性肾炎与特发性膜性肾病的中医证型特点及中医诊治优化方案疗效研究[J].中国医药导报, 2016, 13(24):160-165.
[12]杨敏,刘云启,魏传梅,等.五酯胶囊对CYP3A5基因表达型特发性膜性肾病他克莫司药代动力学影响的初步探索[J].国际泌尿系统杂志, 2016,36(2):223-228.
[2]赵秀玲.他克莫司联合加味黄芪赤风汤治疗老年特发性膜性肾病的临床疗效[J].中国农村卫生, 2018,(14):36.
[3]徐平,何雨荻,于泽铭,等.环孢素A和他克莫司治疗特发性膜性肾病的有效性及安全性比较:网状Meta分析[J].中国医学科学院学报, 2018,40(1):41-51.
[4]黄俊,李剑文,梁鸣,等.他克莫司联合激素治疗血清抗PLA2R抗体持续高滴度的难治性特发性膜性肾病[J].实用医学杂志, 2018, 34(8):1355-1359.
[5]梁艳,张小玲,朱清,等.肾上腺皮质激素联合免疫抑制剂治疗膜性肾病的疗效及与血清PLA2R抗体浓度的相关性[J].广东医学, 2017, 38(12):1897-1900.
[6]高世平,王莉,姚恬.雷公藤多苷联合小剂量激素治疗特发性膜性肾病的疗效及其对患者血清ET-Ⅰ水平的影响[J].海南医学, 2017, 28(20):3284-3286.
[7]彭佳楠,陈孟华,田娜,等.PLA2R基因单核苷酸多态性与特发性膜性肾病患者临床特征及疗效的相关性研究[J].宁夏医科大学学报, 2017,39(5):519-524,前插1.
[8]郭艳红,郑丹侠,王悦.特发性膜性肾病相关抗原M型磷脂酶A2受体和1型血小板反应蛋白7A域的研究进展[J].中国综合临床, 2017, 33(3):280-285.
[9]莫文辉.他克莫司(Tacrolimus)治疗有肾病综合征表现的特发性膜性肾病的临床疗效及安全性[J].齐齐哈尔医学院学报, 2016, 37(6):724-725.
[10]丁蓓蓓,朱小春.特发性膜性肾病患者采用他克莫司与环磷酰胺联合激素治疗的临床效果比较[J].数理医药学杂志, 2016, 29(1):11-13.
[11]任桐,杨洪涛.系膜增生性肾炎与特发性膜性肾病的中医证型特点及中医诊治优化方案疗效研究[J].中国医药导报, 2016, 13(24):160-165.
[12]杨敏,刘云启,魏传梅,等.五酯胶囊对CYP3A5基因表达型特发性膜性肾病他克莫司药代动力学影响的初步探索[J].国际泌尿系统杂志, 2016,36(2):223-228.