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| Clinical effect of Tacrolimus combined with Cyclophosphamide pulse therapy in the treatment of steroid-dependent nephrotic syndrome in children |
| HAN Lin-shan DONG Dan |
| Department of Pharmacy, Central Hospital Affiliated to Shenyang Medical College |
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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.
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| [1] |
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.
|
| [2] |
甄颖，刘山.糖皮质激素与环磷酰胺联合应用治疗难治性肾病综合征的疗效评价[J].中国医药科学，2019，9（23）：61-63.
|
| [3] |
中华医学会儿科学分会肾脏病学组.儿童常见肾脏疾病诊治循证指南（一）：激素敏感、复发/依赖肾病综合征诊治循证指南（试行）[J].中华儿科杂志，2009，47（3）：167-170.
|
| [4] |
丁颖，吴滢，钮小玲，等.儿童原发性肾病综合征合并急性胰腺炎的临床特征分析[J].上海医学，2020，43（6）：375-379.
|
| [5] |
孔令强，李勋，刘梦欣.他克莫司联合醋酸泼尼松治疗原发性肾病综合征的临床疗效及对外周血Th17 和血脂水平的影响[J].检验医学与临床，2020，17（17）：2547-2549.
|
| [6] |
王莉，冯仕品，罗苇，等.玉屏风颗粒联合他克莫司对原发性肾病综合征患儿肾功能、免疫功能以及Th1/Th2 细胞平衡的影响[J].现代生物医学进展，2020，20（17）：3354-3357，3340.
|
| [7] |
倪娜，康文静.他克莫司联合吗替麦考酚酯治疗原发性肾病综合征的效果及对患者肾功能及疾病复发的影响[J].中国实用医刊，2020，47（16）：96-99.
|
| [8] |
龚广欣.他克莫司联合甲泼尼龙对原发性肾病综合征患者HMGB-1、NF-κB 水平的影响[J].中国现代医药杂志，2018，20（5）：74-75.
|
| [9] |
李慧聪，时军，陈宝平，等.甲泼尼龙联合他克莫司治疗老年原发性肾病综合征的效果观察[J].河南医学研究，2018，27（6）：1090-1091.
|
| [10] |
李楠.泼尼松联合他克莫司治疗老年原发性肾病综合征的疗效[J].中国合理用药探索，2018，15（11）：114-116.
|
| [11] |
吴娱，孙晓梅.环磷酰胺与他克莫司治疗男性肾病综合征的效果比较[J].中国当代医药，2020，27（1）：99-101.
|
| [12] |
刘磊.甲泼尼龙联合他克莫司对老年原发性肾病综合征的疗效观察[J].湖北科技学院学报（医学版），2018，32（3）：208-211.
|
| [13] |
李晓娅，王隆.他克莫司对小儿原发性肾病综合征高凝状态及hs-CRP 的影响[J].中国妇幼健康研究，2018，29（9）：1154-1157.
|
| [14] |
涂娴.他克莫司联合醋酸泼尼松治疗原发性肾病综合征的临床疗效[J].黑龙江医学，2019，43（7）：788-789，791.
|
| [15] |
董晓贝，王少亭，胡晓舟，等.他克莫司与环孢素A 治疗原发性肾病综合征的疗效分析[J].世界最新医学信息文摘，2019，19（86）：159-160.
|
| [16] |
黄凌斐，赵晨妍，焦正，等.儿童原发性肾病综合征患者中他克莫司的群体药动学研究[J].药学学报，2018，53（2）：263-270.
|
| [17] |
焦洁茹，李嫣然，陈晓农，等.多项临床指标在经他克莫司联合阿魏酸哌嗪治疗的老年原发性肾病综合征患者中的变化及意义[J].诊断学理论与实践，2019，18（1）：104-106.
|
|
|
|
