Abstract： Objective To observe the clinical effect of Tacrolimus combined with Cyclophosphamide pulse therapy in the treatment of steroid-dependent nephrotic syndrome in children. Methods A total of 160 cases of children with steroid-dependent nephrotic syndrome treated in the Central Hospital Affiliated to Shenyang Medical College from March 2014 to March 2018 were selected as the research subjects and were divided into observation group and control group according to random number table method, with 80 cases in each group. On the basis of oral Prednisone treatment, the control group was given Cyclophosphamide pulse therapy, and the observation group was given Tacrolimus combined with Cyclophosphamide pulse therapy, both groups were treated for 12 months. The 24-hour urinary protein,blood urea nitrogen (BUN), serum creatinine (SCR), retinol binding protein (RBP), blood and urine β2-microglobulin(β2-MG), serum albumin (ALB), cholesterol (Chol), Cystatin C (CysC), D-dimer and fibrinogen (FIB) levels were observed before and 12 months after treatment, and the recurrence rate and incidence of adverse reactions were recorded.Results After treatment, 24 h urinary protein level, BUN, Scr, RBP, β2-MG, ALB, Chol, D-dimer and FIB levels in both groups were lower than before treatment, while CysC level was higher than before treatment, the differences were statistically significant (P<0.05), but there was no significant difference between the two groups (P>0.05). There was no statistical significance in the incidence of adverse reactions such as gastrointestinal reactions, decreased peripheral white blood cells and elevated liver transaminase between the two groups (P>0.05). The recurrence rate of the observation group was lower than that of the control group, and the difference was statistically significant (P<0.05). Conclusion Compared with Cyclophosphamide pulse therapy alone, Tacrolimus combined with Cyclophosphamide pulse therapy in the treatment of children with steroid-dependent nephrotic syndrome has better clinical effect, the recurrence rate was low and the incidence of adverse reactions was not increased, which is worthy of clinical promotion.
韩林珊；董丹. 他克莫司联合环磷酰胺冲击治疗儿童激素依赖型肾病综合征的临床效果[J]. 中国当代医药, 2021, 28(16): 138-141.
HAN Lin-shan；DONG Dan. Clinical effect of Tacrolimus combined with Cyclophosphamide pulse therapy in the treatment of steroid-dependent nephrotic syndrome in children. 中国当代医药, 2021, 28(16): 138-141.
Chan EY，Webb H，Yu E，et al.Both the rituximab dose and maintenance immunosuppression in steroid-dependent/frequently-relapsing nephrotic syndrome have important effects on outcomes[J].Kidney Int，2019，97（2）：393-401.
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