本文選題：他克莫司　切入點：兒童　出處：《浙江大學》2012年碩士論文　論文類型：學位論文

【摘要】：目的分析評估他克莫司對治療兒童激素抵抗型腎病綜合征的療效及其安全性。 方法采用回顧性縱向研究,分析21例激素抵抗型腎病綜合征住院患兒應用他克莫司治療,初始劑量0.1～0.15mg/(kg·d),每12小時1次,定期監(jiān)測血藥濃度、尿常規(guī)、血常規(guī)及肝腎功能等指標。同時口服小劑量潑尼松0.2～0.75mg/(kg·d). 結果1-3個月后觀察近期療效,完全緩解者14例,部分緩解者7例,完全緩解率66.7%。16例患兒接受了腎活檢,其中6例微小病變型腎病患兒中3例完全緩解,3例部分緩解；4例局灶節(jié)段性腎小球硬化患兒中2例完全緩解,2例部分緩解；5例IgM腎病及1例系膜增生性腎小球腎炎患兒均完全緩解。最快顯效時間為2天,中位顯效時間為18天。服藥期間6例患兒出現(xiàn)一過性不良反應,經(jīng)對癥處理后均緩解。治療期間20例患兒獲隨訪,隨訪1年內共4例復發(fā)；在臨床使用他克莫司治療激素抵抗型腎病綜合征患兒達完全緩解1年之后(共7例),共4例6次出現(xiàn)復發(fā)。 結論他克莫司對兒童激素抵抗型腎病綜合征有很好的療效,服用后不良反應少,大多可耐受,但患兒服藥1～2年后復發(fā)率較高,是否與患兒本身病情較頑固、藥物繼發(fā)耐藥等因素有關,目前不能明確,因此他克莫司治療激素抵抗型腎病綜合征的長期療效仍有待于進一步隨訪觀察。
[Abstract]:Objective to evaluate the efficacy and safety of tacrolimus in the treatment of steroid-resistant nephrotic syndrome in children. Methods 21 hospitalized children with steroid-resistant nephrotic syndrome were treated with tacrolimus at an initial dose of 0.1 ~ 0.15 mg / kg 路dl, once every 12 hours. Blood routine examination, liver and kidney function, and oral administration of low dose prednisone 0.75 mg / kg / d. Results after 1-3 months, there were 14 cases of complete remission and 7 cases of partial remission. The complete remission rate was 66.7.16 cases received renal biopsy. Of the 6 cases of minimal change nephropathy, 3 cases of complete remission 3 cases of partial remission 4 cases of focal segmental glomerulosclerosis 2 cases of complete remission 2 cases of partial remission of 5 cases of IgM nephropathy and 1 case of Mesangial proliferative glomerular kidney disease. All the children were completely relieved. The most effective time was 2 days. The median effective time was 18 days. Transient adverse reactions were found in 6 children during the course of medication, which were all alleviated after symptomatic treatment. During the treatment, 20 cases were followed up and 4 cases recurred during the 1-year follow-up. One year after tacrolimus was used in the treatment of steroid-resistant nephrotic syndrome (7 cases were treated with tacrolimus, 4 cases recurred 6 times). Conclusion tacrolimus has a good curative effect on steroid-resistant nephrotic syndrome in children. The adverse reactions after taking tacrolimus are few, most of them can be tolerated, but the recurrence rate is higher after taking tacrolimus for 1 ~ 2 years. Drug resistance and other factors are not clear, so the long-term efficacy of tacrolimus in the treatment of steroid-resistant nephrotic syndrome remains to be further followed up.
【學位授予單位】：浙江大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R726.9

【引證文獻】

相關期刊論文 前1條

1 任睿;;他克莫司治療老年激素抵抗型腎病綜合征的臨床探討[J];中國處方藥;2015年06期

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本文編號：1609774