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

【摘要】：目的分析評(píng)估他克莫司對(duì)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(yīng)用他克莫司治療,初始劑量0.1～0.15mg/(kg·d),每12小時(shí)1次,定期監(jiān)測(cè)血藥濃度、尿常規(guī)、血常規(guī)及肝腎功能等指標(biāo)。同時(shí)口服小劑量潑尼松0.2～0.75mg/(kg·d). 結(jié)果1-3個(gè)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(shí)間為2天,中位顯效時(shí)間為18天。服藥期間6例患兒出現(xiàn)一過(guò)性不良反應(yīng),經(jīng)對(duì)癥處理后均緩解。治療期間20例患兒獲隨訪,隨訪1年內(nèi)共4例復(fù)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(dá)完全緩解1年之后(共7例),共4例6次出現(xiàn)復(fù)發(fā)。 結(jié)論他克莫司對(duì)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(yīng)少,大多可耐受,但患兒服藥1～2年后復(fù)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(guān),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(zhǎng)期療效仍有待于進(jìn)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(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R726.9

【引證文獻(xiàn)】

相關(guān)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(guó)處方藥;2015年06期

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本文編號(hào)：1609774