CAJ | 학술논문

目的：观察长疗程他克莫司联合小剂量激素治疗特发性膜性肾病的疗效和安全性。方法选择常州第一人民医院2012年3月至2015年5月经肾穿刺活检确诊为特发性膜性肾病的患者54例,随机分为短疗程组27例和长疗程组27例,短疗程组给予激素联合他克莫司治疗12个月,长疗程组治疗24个月,观察两组的疗效、安全性及复发等情况。结果5例患者因发生严重不良反应退出研究。短疗程组24例,6例获得完全缓解,12例部分缓解,6例无效；治疗结束后6例复发。长疗程组25例,10例获得完全缓解,13例获得部分缓解,2例无效；治疗结束后2例复发。结论长疗程他克莫司联合小剂量激素可有效治疗特发性膜性肾病,缓解率更高,且复发率低。
목적：관찰장료정타극막사연합소제량격소치료특발성막성신병적료효화안전성。방법선택상주제일인민의원2012년3월지2015년5월경신천자활검학진위특발성막성신병적환자54례,수궤분위단료정조27례화장료정조27례,단료정조급여격소연합타극막사치료12개월,장료정조치료24개월,관찰량조적료효、안전성급복발등정황。결과5례환자인발생엄중불량반응퇴출연구。단료정조24례,6례획득완전완해,12례부분완해,6례무효；치료결속후6례복발。장료정조25례,10례획득완전완해,13례획득부분완해,2례무효；치료결속후2례복발。결론장료정타극막사연합소제량격소가유효치료특발성막성신병,완해솔경고,차복발솔저。
ABSTRACT:Objective To observe therapeutic effect and safety of prolonged tacrolimus combined with small dose of hormone on idiopathic membranous nephropathy (IMN )with nephrotic syndrome in different courses of treatment.Methods A total of 54 patients with IMN were randomly divided into short-term (n =27)and long-term ( n =27)groups.All patients received initial treatment with tacrolimus and prednisone for 6 months,and afterward tapered with low-dose tacrolimus until 12 months (short-term )and 24 months (long-term ).Treatment effects, recurrence and side effects were observed in two groups.Results Five patients quitted study due to severe side effects. Six patients obtained complete remission and 12 patients obtained partial remission after 12 months of treatment in the short-term group;6 patients had no response.10 patients obtained complete remission and 13 patients obtained partial remission after 24 months of treatment in the long-term group;One patient had no response.Six patients relapsed in the short-term group after tacrolimus withdrawal,while only two patients suffered from recurrence in the long-term group.Conclusion Prolonged tacrolimus combined with prednisone can relieve IMN significantly with lower recurrence rate.