| 孙娴静,汪丽丽,曹娟.他克莫司与环磷酰胺治疗特发性膜性肾病的疗效比较[J].安徽医药,2020,24(5):1014-1017. |
| 他克莫司与环磷酰胺治疗特发性膜性肾病的疗效比较 |
| Comparison of clinical efficacy between tacrolimus and cyclophosphamide in patients with idiopathic membranous nephropathy |
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| DOI：10.3969/j.issn.1009?6469.2020.05.042 |
| 中文关键词: 肾小球肾炎，膜性 他克莫司 环磷酰胺 卵泡刺激素 雌二醇 血清白蛋白 白蛋白尿 |
| 英文关键词: Glomerulonephritis,membranous Tacrolimus Serum albumin Albuminuria |
| 基金项目:江苏省卫生计生委医学科研课题(Z201525) |
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| 中文摘要: |
| 目的比较他克莫司与环磷酰胺治疗特发性膜性肾病的效果。方法选取 2017年 4月至 2018年 4月东南大学附属中大医院江北院区收治的特发性膜性肾病病人 112例，按随机数字表法分为两组，各 56例。对照组采用环磷酰胺治疗，观察组采用他克莫司治疗。对比两组治疗前后血清白蛋白、 24 h尿蛋白、血清性激素水平变化及不良反应发生率。结果观察组治疗 3个月后血清白蛋白水平( 36.58±1.18)g/L高于对照组( 31.37±1.25)g/L，24 h尿蛋白水平( 1.74±0.51)g低于对照组( 2.96±0.63)g，差异有统计学意义( P＜0.05)；观察组治疗 3个月后卵泡生成激素( FSH)(6.16±0.84)mIU/mL、雌二醇( E2)(40.05±2.74)pg/mL、水平均高于对照组［(5.21±0.92)mIU/mL、(33.94±2.51)pg/mL］(P＜0.05)孕酮( P)(0.83±0.09)ng/mL、睾酮( T)(436.73±16.68) ng/dL水平均低于对照组( 1.17±0.11)ng/mL、(458.53±17.83)ng/dL(P＜0.05)，。黄体生成激素( LH)(5.21±0.88)mIU/mL、催乳激素( PRL)(7.38±1.17)ng/mL与对照组( 5.19±0.95)mIU/mL、(7.49±1.13)ng/mL相比，差异无统计学意义( P＞0.05)；观察组治疗期间转氨酶异常增高、胃肠道反应及骨髓抑制发生率均低于对照组，差异有统计学意义( P＜0.05)。结论他克莫司较环磷酰胺治疗特发性膜性肾病临床疗效更好，且病人不良反应少，值得临床推广。 |
| 英文摘要: |
| Objective To investigate the effect of tacrolimus and cyclophosphamide in the treatment of patients with idiopathicmembranous nephropathy.Methods A total of 112 patients with idiopathic membranous nephropathy admitted to Jiangbei Hospital of Southeast University from April 2017 to April 2018 were enrolled.The patients were divided into two groups according to the ran?dom number table，56 cases each.The control group was treated with cyclophosphamide，and the observation group was treated with tacrolimus.The changes of serum albumin，24h urine protein，serum sex hormone levels and adverse reactions were compared be? fore and after treatment.Results The serum albumin level of the observation group was higher than that of the control group［( 36.58±1.18)vs.(31.37±1.25)g/L］after 3 months of treatment.The 24 h urine protein level was lower than that of the control group［( 1.74±0.51)vs.(2.96±0.63)g］(P＜0.05).The FSH［( 6.16±0.84)vs.(5.21±0.92)mIU/mL］and E2［( 40.05±2.74)vs.(33.94±2.51)pg/mL］levels were high after 3 months of treatment in the observation group.In the control group(P＜0.05)，the P［(0.83±0.09)vs.(1.17±0.11)ng/mL］and T［(436.73±16.68)vs.(458.53±17.83)ng/dL］levels were lower than the control group(P＜0.05).There was no significant difference between LH［( 5.21±0.88)vs.(5.19±0.95)mIU/mL］and PRL［( 7.38±1.17)vs.(7.49±1.13)ng/mL］compared with the control group(P＞0.05).The abnormal increase of transaminase，gastrointestinal reaction and myelosuppression rate in the observation group were lower than those in the control group，the difference was statistically signif? icant(P＜0.05).Conclusion Tamoximus is more effective than cyclophosphamide in the treatment of idiopathic membranous ne? phropathy，with few adverse reactions and worthy of clinical promotion. |
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