摘要
目的探讨他克莫司联合甲泼尼龙治疗狼疮性肾炎的疗效分析及安全性评价。方法将2012年11月—2015年10月金华市中心医院收治的64例狼疮性肾炎患者分为研究组和对照组,每组32例。研究组采用他克莫司联合甲泼尼龙治疗。对照组采用环磷酰胺联合甲泼尼龙治疗。对比2组缓解率、不良反应的情况。记录2组患者治疗前后24 h尿蛋白定量、血肌酐(Scr)、C3、血白蛋白(ALB)、系统性红斑狼疮疾病活动性指数(SLEDAI)评分的水平变化。结果研究组疗效显著优于对照组,差异有统计学意义(Z=2.223,P<0.05);2组治疗后24 h尿蛋白定量、血肌酐(Scr)、系统性红斑狼疮疾病活动性指数(SLEDAI)评分显著降低,C3、血白蛋白(ALB)显著升高,差异有统计学意义(P<0.05);治疗后,研究组的24 h尿蛋白定量、SLEDAI评分显著低于对照组,Scr、C3、ALB显著高于对照组,差异有统计学意义(t=4.538、3.896、2.287、5.492、6.342,P<0.05);研究组不良反应发生率(15.62%)显著低于对照组(40.62%),差异有统计学意义(χ~2=4.947,P<0.05)。结论他克莫司联合甲泼尼龙治疗狼疮性肾炎疗效确切,能显著降低尿蛋白水平,有效控制病情,且安全性较高。
Objective To investigate the curative effect and safety of tacrolimus combined with methylprednisolone analysis in the treatment of lupus nephritis. Methods Total 64 cases of lupus nephritis in our hospital between November, 2012 and October,2015 were enrolled and divided into study group and control group ,32 cases in each group. The study group received tacrolimus combined with methylprednisolone, while the control group received cyclophosphamide and methylprednisolone treatment. The remission rate, incidence of adverse reactions was compared between the two groups. The levels of 24-hour urine protein, serum creatinine （Scr） , C3, serum albumin （ ALB ） , and systemic lupus erythematosus disease activity index （SLEDAI） score were recorded before and after treatment in both groups. Results The effect in the study group was significantly better than that in the control group, the difference was statistically significant（ Z = 2. 223, P 〈 0.05 ）. After the treatment, the levels of 24-hour urine protein, Scr and SLEDAI decreased, and levels of C3 and ALB significantly increased in both groups, the difference was statistically significant （ P 〈 0.05 ）. The levels of 24-hour urine protein and SLEDAI in the study group were lower than those in the control group, but the levels of Scr, C3 and ALB were significantly higher than those in the control group, the difference was statistically significant （t = 4. 538,3. 896,2. 287, 5. 492,6. 342 ,P 〈 0.05 ）. The incidence rate of adverse reaction in the study group （15.62%） was significantly lower than that （ 40. 62% ） Of the control group, the difference was statistically significant （ Х^2 = 4. 947, P 〈 0. 05 ）. Conclusion Tacrolimus combined with methylprednisolone has definite efficacy for lupus nephritis, which can significantly reduce the urinary protein level, effectively control of the disease, and with a high safety.
出处
《中华全科医学》
2017年第8期1342-1344,共3页
Chinese Journal of General Practice
基金
浙江省自然基金项目(Y2100650)
关键词
他克莫司
甲泼尼龙
狼疮性肾炎
尿蛋白
白蛋白
Tacrolimus
Methylprednisolone
Lupus nephritis
Urine protein
Albumin
