摘要
目的 探讨他克莫司对激素抵抗型肾病综合征患者Th1/Th2平衡失调及机体自身免疫的影响.方法 选取2014年1月至2015年12月68例激素抵抗型肾病综合征患者,根据用药方案不同分为对照组与研究组,每组34例.对照组采用环磷酰胺治疗,研究组采用他克莫司治疗,两组均持续治疗3个月.对比治疗前后两组24 h尿蛋白、血浆白蛋白、总胆固醇水平及血清炎性因子[白细胞介素-2（IL-2）、白细胞介素-13（IL-13）、干扰素-γ（INF-γ）]水平变化情况,统计两组临床疗效及不良反应发生率.结果 治疗前两组24 h尿蛋白、血浆白蛋白、总胆固醇、IL-2、IL-13、INF-γ水平对比差异未见统计学意义（P〉0.05）,经治疗,研究组各指标水平明显优于对照组,差异有统计学意义（P〈0.05）;研究组总有效率（88.24%）明显高于对照组（64.71%）,差异有统计学意义（P〈0.05）;研究组不良反应发生率（8.82%）显著低于对照组（32.35%）,差异有统计学意义（P〈0.05）.结论 采用他克莫司治疗激素抵抗型肾病综合征效果显著,可有效增加血浆白蛋白水平,降低24 h尿蛋白及总胆固醇水平,改善IL-2、IL-13、INF-γ水平,纠正Th1/Th2平衡失调,抑制自身免疫反应,且不良反应发生率较低,具有安全性.
Objective To investigate the effects of tacrolimus on the balance of Th1/Th2 in patients with steroid resistant nephrotic syndrome and its immune effect.Methods From January 2014 to December 2015, 68 patients with steroid resistant nephrotic syndrome treated in hospital were selected.According to the different treatment schemes, they were divided into control group and study group, with 34 cases in each group.The control group was treated with cyclophosphamide, and the study group was treated with tacrolimus, the two groups were treated for 3 months.Before and after treatment, the 24 h urinary protein, serum albumin, total cholesterol and serum inflammatory factor [interleukin-2（IL-2）, interleukin-13（IL-13） and interferon gamma （INF-γ）] level changes, and the adverse reaction rates of two groups, clinical curative effects were compared.Results There was no significant difference in the 24 h urinary protein, serum albumin, total cholesterol, IL-2, IL-13 or INF-γ levels before treatment （P〉0.05）.After treatment, each index in the study group was significantly better than that in the control group, the differences were significant （P〈0.05）.The total effective rate of the study group （88.24%） was significantly higher than that of the control group （64.71%）, and the difference was significant （P〈0.05）.The incidence of adverse reactions （8.82%） in the study group was significantly lower than that in the control group （32.35%）, and the difference was significant （P〈0.05）.Conclusions The effect of tacrolimus on steroid resistant nephrotic syndrome is significant, it can effectively increase the plasma albumin level, reduce the 24 h urinary protein and total cholesterol, IL-2, IL-13, INF-γ levels, correct the imbalance of Th1/Th2 and inhibit the autoimmune response, and has low incidence of adverse reaction and high safety.
出处
《中国实用医刊》
2017年第11期101-104,共4页
Chinese Journal of Practical Medicine
