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纸质出版:2016
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李丽娜,赵洪雯,申兵冰,梅玫,吴雄飞.他克莫司与吗替麦考酚酯治疗紫癜性肾炎的回顾性对照研究[J].陆军军医大学学报(原第三军医大学学报),2016,38(10):1173-1177.
Li Lina,Zhao Hongwen,Shen Bingbing,Mei Mei,Wu Xiongfei.Tacrolimus versus mycophenolate mofetil for therapy of Henoch-Schonlein purpura nephritis: a retrospective comparison trial[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(10):1173-1177.
李丽娜,赵洪雯,申兵冰,梅玫,吴雄飞.他克莫司与吗替麦考酚酯治疗紫癜性肾炎的回顾性对照研究[J].陆军军医大学学报(原第三军医大学学报),2016,38(10):1173-1177. DOI:
Li Lina,Zhao Hongwen,Shen Bingbing,Mei Mei,Wu Xiongfei.Tacrolimus versus mycophenolate mofetil for therapy of Henoch-Schonlein purpura nephritis: a retrospective comparison trial[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(10):1173-1177. DOI:
目的 探讨他克莫司与吗替麦考酚酯治疗Ⅲ~Ⅴ型过敏性紫癜性肾炎(henoch-schonlein purpura nephritis,HSPN)的疗效及安全性。 方法 回顾性对照研究我院2012年1月至2015年11月病理分型为Ⅲ~Ⅴ型HSPN患者58例,根据口服的特殊免疫抑制剂的种类分为两组,30例口服他克莫司(tacrolimus,TAC)0.05~0.1 mg/(kg·d)(TAC组),28例口服吗替麦考酚酯(mycophenolate mofetil
MMF)0.75~1.0 g/d(MMF组),两组均同时口服足量泼尼松。以缓解率、平均缓解时间、尿蛋白、血清白蛋白(Alb)及尿沉渣镜检红细胞计数作为疗效指标,以不良反应的发生率为安全指标进行比较。 结果 治疗前两组的临床特征和病理积分等基线指标差异无统计学意义(P0.05)。两组治疗后尿蛋白定量和尿沉渣镜检红细胞计数均下降,血浆白蛋白均升高,且与基线值比较差异均有统计学意义(P0.05),但两组的变化程度差异无统计学意义(P0.05)。治疗前后两组的血肌酐(Scr)、估算肾小球滤过率(eGFR)、缓解率及平均缓解时间差异均无统计学意义(P0.05)。TAC组不良反应发生率为23.3%(7/30),主要为高血糖、震颤、脱发等;MMF组不良反应发生率为50.0%(14/28),主要为咳嗽增多、失眠、高胆固醇血症等。两组比较差异有统计学意义(P0.05)。 结论 TAC治疗Ⅲ~Ⅴ型HSPN与MMF疗效相当,且TAC不良反应发生率低。
Objective To explore the efficacy and safety of tacrolimus (TAC) and mycophenolate mofetil (MMF) in the treatment of type Ⅲ~Ⅴ Henoch-Schonlein purpura nephritis (HSPN). Methods A retrospective comparison trial of 58 type Ⅲ~Ⅴ HSPN patients in our hospital from January 2012 to November 2015 was performed. According to the types of special immunosuppressants
these patients were divided into TAC group (n=30) which was treated with oral TAC 0.05~0.1 mg/(kg·d)
and MMF group (n=28) which was treated with oral MMF 0.75~1.0 g/d. Both groups received the full-dose prednisone. The remission rate
average remission time
proteinuria
serum albumin and red blood cell count of urine microscopy were taken as the efficacy variables
while the incidence of adverse reactions was taken as the safety indicator. Results General information of the 2 groups
including clinical and pathological characteristics at baseline
had no statistical difference before treatment (P0.05). After treatment
proteinuria and red blood cell count of urinary sediment under microscopic examination decreased significantly in both groups
and serum albumin increased significantly (P0.05). However
the degree of variation had no statistical difference between the 2 groups (P0.05). Serum creatinine
estimated glomerular filtration rate (eGFR)
remission rate and average remission time were not statistically significant before and after treatment in both groups (P0.05). Adverse reactions between the TAC group (mainly hyperglycemia
tremors
alopecia
etc) and the MMF group (mainly increased cough
insomnia
hypercholesterolemia
etc) were significantly different (7/30 vs 14/28
23.3% vs 50.0%
P0.05). Conclusion TAC is non-inferior to MMF for therapy of HSPN and has lower adverse reactions.
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