中国药房2016，Vol.27Issue(32)：4528-4530,4531,4.DOI:10.6039/j.issn.1001-0408.2016.32.20
甲泼尼龙联合他克莫司治疗老年原发性肾病综合征的临床观察
Clinical Observation of Methylprednisolone Combined with Tacrolimus in the Treatment of Elderly Patients with Primary Nephrotic Syndrome
摘要
Abstract
OBJECTIVE:To explore the clinical efficacy of methylprednisolone combined with tacrolimus in the treatment of elderly patients with primary nephrotic syndrome and their effects on natural killer(NK)cells,T lymphocyte subsets and histocom-patibility complex(MHC)Ⅱ level. METHODS:88 elderly patients with primary nephrotic syndrome were selected and divided in-to single drug group and drug combination group,with 44 cases in each group. Single drug group was given Methylprednisolone tablet 0.8 mg/kg,qd (morning),gradually decreasing to 4 mg/d. Drug combination group was additionally given Tacrolimus cap-sule 0.025 mg/kg,q12 h(1 h after meal),adjusting drug dosage according to plasma concentration. Treatment course of 2 groups lasted for 6 months. Clinical efficacies of 2 groups were observed as well as 24 h urinary protein quantitation,serum albumin,re-nal function indexes(SCr,BUN),TC,FIB,the number of NK,T lymphocytes subset(CD4+,CD8+,CD4+/CD8+),MHCⅡ lev-el before and after treatment. The occurrence of ADR was recorded. RESULTS:Total effective rate(72.73%)of drug combination group was significantly higher than that of single drug group(40.91%),with statistical significance(P=0.003). Before treatment, there was no statistical significance in above indexes between 2 groups(P>0.05). After treatment,above indexes of 2 groups were improved significantly,and the improvement of 24 h urinary protein quantitation,serum albumin,SCr,BUN,FIB,NK cells,T lymphocytes subset and MHCⅡ level in drug combination group were significantly better than in single drug group,with statistical significance (P<0.05). The incidence of ADR in single drug group (6.82%) was slightly lower than in drug combination group (9.09%),without statistical significance(P=0.694). CONCLUSIONS:Methylprednisolone combined with tacrolimus have signifi-cant therapeutic efficacy in the treatment of elderly primary nephrotic syndrome,can improve NK cells and T lymphocyte subsets level and decrease the expression of MHCⅡwith good safety.关键词
甲泼尼龙/他克莫司/老年原发性肾病综合征/T淋巴细胞亚群/自然杀伤细胞/组织相容性复合体ⅡKey words
Methylprednisolone/Tacrolimus/Elderly primary nephrotic syndrome/T lymphocyte subsets/NK cells/MHCⅡ分类
医药卫生引用本文复制引用
邓时素,欧三桃..甲泼尼龙联合他克莫司治疗老年原发性肾病综合征的临床观察[J].中国药房,2016,27(32):4528-4530,4531,4.基金项目
四川省卫生和计划生育委员会科研课题 （）
