山东医药2016，Vol.56Issue(46)：11-14,4.DOI:10.3969/j.issn.1002-266X.2016.46.003
他克莫司与环磷酰胺对特发性膜性肾病患者疗效及性激素水平影响的比较
Comparison in effects of tacrolimus and cyclophosphamide on efficacy and sex hormone levels in patients with idiopathic membranous nephropathy
摘要
Abstract
Objective To investigate the effects of tacrolimus combined with glucocorticoid on the levels of sex hor-mones in patients with idiopathic membranous nephropathy (IMN).Methods Forty-six IMN patients with the performance of nephrotic syndrome were divided into the tacrolimus group (28 cases)and the control group (18 cases).The tacrolimus group was given tacrolimus capsules 0.05-0.1 mg/(kg·d),twice a day on an empty stomach and prednisone acetate tab-lets with starting dose of 0.5 mg/(kg·d),morning orally,1 time /d,and after 8 weeks we reduced the dose.The control group was treated with 0.8 g cyclophosphamide by intravenous drip,1 time every 2 weeks,together with prednisone 1 mg/(kg·D)morning orally,1 time/d,and after 8 weeks we reduced the dose.These two groups were treated for 3 months. Before treatment,1 and 3 months after treatment,24 h urinary protein quantitative level and serum albumin level were de-tected in the two groups as well as the sex hormone testosterone (T),estradiol (E2),follicle stimulating hormone,luteini-zing hormone (FSH)hormone (LH),prolactin (PRL)and sex hormone binding globulin (SBG)levels.Results Com-pared with that before treatment,24-hour urinary protein quantitative level reduced,the serum albumin level increased the tacrolimus group at 1 month after treatment (all P<0.05),and in the cyclophosphamide group at 1 month after treatment, 24-hour urinary protein quantitative level reduced (P<0.05).At 3 months after treatment,24-hour urinary protein quanti-tative level decreased and the serum albumin level increased (all P<0.05).Compared with the cyclophosphamide group, 24-hour urinary protein quantitative level decreased,and the serum albumin level increased in the tacrolimus group at 1 and 3 months after treatment (all P<0.05).At 3 months after treatment,the levels of serum E2,T and SBG were decreased, and the FSH and LH levels were increased as compared with that before treatment (all P<0.05).At 3 months after treat-ment,the serum levels of E2 ,T and SBG in the tacrolimus group were higher than those in the control group,and the FSH level was lower than that in the control group (all P<0.05 ).The incidence of adverse reactions in the tacrolimus group was lower than that in the control group (P<0.05 ).Conclusion Compared with the cyclophosphamide scheme,the ta-crolimus scheme for IMN patients with clinical manifestation of nephrotic syndrome takes effect faster and better,and has less inhibitory effect on the sex hormones.关键词
特发性膜性肾病/性激素/他克莫司/环磷酰胺Key words
sex hormones/tacrolimus/cyclophosphamide/idiopathic membranous nephropathy分类
医药卫生引用本文复制引用
郭醉爽,王建生,郭明好,张文吉,马东红,张宛哲,孟晶茜,刘云..他克莫司与环磷酰胺对特发性膜性肾病患者疗效及性激素水平影响的比较[J].山东医药,2016,56(46):11-14,4.基金项目
河南省科技发展计划项目（142102310300）。 （）
