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| Effect comparison of Tacrolimus and Cyclophosphamide in the treatment of refractory nephrotic syndrome in children |
| LIU Ying GAO Jian▲ |
| Department of Pediatric, General Hospital of Fuxin Mining, Liaoning Health Industry Group, Liaoning Province, Fuxin 123000, China |
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Abstract Objective To explore the clinical application value of Tacrolimus and Cyclophosphamide in children with refractory nephrotic syndrome. Methods Seventy-eight children with refractory nephrotic syndrome admitted to General Hospital of Fuxin Mining, Liaoning Health Industry Group from April 2018 to September 2020 were selected as the research subjects. According to the random number table method, they were divided into the control group and the study group, with 39 cases in each group. Children in the control group were treated with intravenous Cyclophosphamide, and the children in the study group were treated with oral Tacrolimus. The course of treatment in both groups was six months. The total clinical effective rate, regulatory T cells, peripheral blood endothelin-1 (ET-1), toll like receptor 7(TLR-7) mRNA, nuclear transcription factor κB (NF-κB), high mobility group protein-1 (HMGB-1) level and related indexes of renal function were compared between the two groups. Results The total effective rate of 3 and 6 months after treatment was higher than 1 month after treatment in the two groups, the difference was statistically significant (P＜0.05). After 3 and 6 months of treatment, the total effective rate of the study group was higher than that of the control group, the difference was statistically significant (P＜0.05). After treatment, CD4+, CD4+/CD8+ and glomerular filtration rate in the study group were higher than those in the control group, CD8+, ET-1, TLR-7 mRNA, NF-κB, HMGB-1, 24 h urinary protein, urinary kidney injury molecule-1 (KIM-1), n-acetyl-β-d glucosaminidase (NAG) levels were lower than those in the control group, and the differences were statistically significant (P＜0.05). Conclusion Tacrolimus is effective in treating children with refractory nephrotic syndrome. It can remarkably improve the renal functions of patients and has certain clinical application value.
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