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他克莫司治療特發(fā)性膜性腎病的臨床觀察

發(fā)布時(shí)間:2018-06-28 20:23

  本文選題:特發(fā)性膜性腎病 + 免疫抑制劑; 參考:《吉林大學(xué)》2014年碩士論文


【摘要】:目的: 通過(guò)與經(jīng)典的激素聯(lián)合環(huán)磷酰胺(cyclophoshhamide,CTX)相比較,觀察激素聯(lián)合他克莫司(tacrolimus,TAC)在短期內(nèi)治療特發(fā)性膜性腎病(idiopathic membranous nephropathy,IMN)的療效及安全性。 方法: 選取我院腎病科2008年10月至2013年9月經(jīng)腎穿刺活檢術(shù)后明確診斷為特發(fā)性膜性腎病患者,臨床表現(xiàn)為腎病綜合征,接受免疫抑制治療,且治療后6個(gè)月內(nèi)隨訪資料完整,共計(jì)20例,分為他克莫司組(A組)和環(huán)磷酰胺組(B組)。觀察兩組患者治療前后的血清白蛋白和24小時(shí)尿蛋白定量變化,以及藥物帶來(lái)的不良反應(yīng)。 結(jié)果: 治療6個(gè)月后,他克莫司組緩解率84.6%(11/13),環(huán)磷酰胺組緩解率71.4%(5/7),差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。與治療前相比較,兩組患者治療后血清白蛋白明顯上升(P0.05),24小時(shí)尿蛋白定量明顯下降(P0.05)。兩組同一時(shí)間相互比較,他克莫司組血清白蛋白和24小時(shí)尿蛋白定量較環(huán)磷酰胺組明顯改善(P0.05)。治療6個(gè)月內(nèi),兩組患者未見(jiàn)嚴(yán)重不良反應(yīng)。 結(jié)論: 激素聯(lián)合他克莫司治療治療特發(fā)性膜性腎病有效,,且起效快,短期效果可能優(yōu)于激素聯(lián)合環(huán)磷酰胺。
[Abstract]:Objective:
By comparing with the classic hormone combined with cyclophosphamide (cyclophoshhamide, CTX), the efficacy and safety of hormone combined with tacrolimus (TAC) in the short-term treatment of idiopathic membranous nephropathy (idiopathic membranous nephropathy, IMN) was observed.
Method:
The diagnosis of idiopathic membranous nephropathy in the Department of nephropathy of our hospital from October 2008 to 2013, 9 menstruation, was diagnosed as idiopathic membranous nephropathy. The clinical manifestations were nephrotic syndrome and received immunosuppressive therapy, and the follow-up data were complete within 6 months after treatment. A total of 20 cases were divided into the tacrolimus group (group A) and the cyclophosphamide group (group B). The treatment of the treatment of two groups of patients was observed. Changes in serum albumin and 24 hours urine protein before and after treatment, as well as adverse drug reactions.
Result:
After 6 months of treatment, the remission rate of the tacrolimus group was 84.6% (11/13) and the remission rate of cyclophosphamide group was 71.4% (5/7). The difference was not statistically significant (P0.05). Compared with the pre treatment, the serum albumin increased significantly in the two groups (P0.05), and the urine protein decreased significantly (P0.05) in 24 hours (P0.05). The two groups were compared with each other at the same time in the tacrolimus group. Protein and 24 hours urine protein were significantly improved compared with cyclophosphamide group (P0.05). No serious adverse reactions occurred in the two groups during 6 months of treatment.
Conclusion:
Hormone combined with tacrolimus is effective and effective in the treatment of idiopathic membranous nephropathy. The short-term effect may be better than that of glucocorticoid combined with cyclophosphamide.
【學(xué)位授予單位】:吉林大學(xué)
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2014
【分類號(hào)】:R692

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 劉志紅;;膜性腎病的治療[J];腎臟病與透析腎移植雜志;2009年04期



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