| 他克莫司联合环磷酰胺和糖皮质激素治疗狼疮性肾炎的疗效观察 |
| 投稿时间：2017-10-18 修订日期：2017-10-25 点此下载全文 |
| 引用本文：秦登优,伍正彬,田恩,邓军辉,祁海峰.他克莫司联合环磷酰胺和糖皮质激素治疗狼疮性肾炎的疗效观察[J].医学研究杂志,2018,47(7):141-144 |
| DOI：
10.11969/j.issn.1673-548X.2018.07.033 |
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| 中文摘要:目的 研究他克莫司联合环磷酰胺和糖皮质激素治疗狼疮性肾炎的疗效。方法 采用随机对照的方法，将2014年9月~2017年9月笔者医院接诊96例狼疮性肾炎的患者随机分为对照组（n=48）和试验组（n=48）。对照组联合使用环磷酰胺和糖皮质激素进行治疗，试验组患者在此基础上联合他克莫司进行治疗。比较两组患者治疗前一般临床资料、治疗后疗效评级与疗效相关指标、肾功能的改善、血清炎性因子水平及患者满意度。结果 两组患者的年龄、性别比、病程、病理分型等一般临床资料相比较，差异无统计学意义（P>0.05）。治疗后，试验组有效率显著高于对照组（89.58% vs 52.08%，P<0.05）。试验组Scr、ds-DNA、C3、SLE-DAI改善幅度均高于对照组，差异有统计学意义（P<0.05）。两组患者尿蛋白定量、血清白蛋白、血肌酐、尿素氮和血清炎性因子均明显下降，但试验组改善幅度优于对照组，差异有统计学意义（P<0.05）。试验组不良反应发生率略高于对照组，但差异无统计学意义（41.67% vs 37.50%，P>0.05）。治疗后试验组患者满意度显著高于对照组，差异有统计学意义（70.83% vs 47.92%，P<0.05）。结论 联合应用他克莫司和环磷酰胺及糖皮质激素治疗狼疮性肾炎的疗效优于环磷酰胺与糖皮质激素联用，且不明显增加不良反应，治疗后患者满意度更高，值得在临床上推广应用。 |
| 中文关键词:狼疮性肾炎 他克莫司 环磷酰胺 糖皮质激素 |
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| Efficacy of Tacrolimus Combined with Cyclophosphamide and Glucocorticoid in the Treatment of Lupus Nephritis |
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| Abstract:Objective To study the efficacy of tacrolimus combined with cyclophosphamide and glucocorticoid in the treatment of lupus nephritis. Methods A total of 96 patients from September 2014 to September 2017 with lupus nephritis were randomly divided into control group (n=48) and experimental group (n=48). The control group was treated with cyclophosphamide and glucocorticoid, and the patients in the experimental group were treated with tacrolimus combined with cyclophosphamide and glucocorticoid. The general clinical data before treatment, efficacy of treatment and efficacy related indicators, improvement of renal function, serum inflammatory factor levels and patient satisfaction were compared between the two groups. Results There were no significant differences between the two groups in age, sex ratio, course of disease, pathological type and other general clinical data (P>0.05). The effective rate of experimental group was higher than that of the control group (89.58% vs 52.08%, P<0.05). The improvement Scr, ds-DNA, C3 and SLE-DAI in the experimental group was significantly higher than that in the control group (P<0.05). The levels of urinary protein, serum albumin, serum creatinine, urea nitrogen and serum inflammatory factors were significantly decreased in both two groups, but the improvement was higher than those of the control group (P<0.05). The incidence of adverse reactions in the experimental group was slightly higher than that in the control group, but the difference was not statistically significant (41.67% vs 37.50%, P>0.05). The satisfaction rate of the patients in the experimental group was significantly higher than that in the control group (70.83% vs 47.92%, P<0.05). Conclusion The combination of tacrolimus and cyclophosphamide and glucocorticoid in the treatment of lupus nephritis is superior to combination of cyclophosphamide and glucocorticoid with higher satisfaction rate and no significant increase in side effects, and thus is worthy of clinical application. |
| keywords:Lupus nephritis Tacrolimus Cyclophosphamide Glucocorticoid |
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