他克莫司治疗肾病综合征临床疗效及其对T淋巴细胞亚群影响研究

Clinical Efficacy of Tacrolimus in the Treatment of Nephrotic Syndrome and Its Influence on T Lymphocyte Subsets

关键词:  他克莫司  肾病综合征  临床疗效  T淋巴细胞亚群  安全性  肾功能指标

Key words:  tacrolimus  nephrotic syndrome  clinical efficacy  T lymphocyte subsets  security  renal function index

摘要:

目的 探讨他克莫司治疗肾病综合征临床疗效及其对T淋巴细胞亚群影响。方法 选取2017年12月—2019年12月邢台市人民医院收治的肾病综合征患者105例作为研究对象，按随机数字表法将其分为观察组（n=54）与对照组（n=51），对照组予以泼尼松片治疗，观察组予以他克莫司治疗。对比2组临床治疗效果、T淋巴细胞亚群、肾功能指标血清肌酐（serum creatinine，Scr）、血尿素氮（blood urea nitrogen，BUN）、血清白蛋白（albumin，ALB）、24 h尿蛋白定量、血清三酰甘油（triacylglycerol，TG）、总胆固醇（total cholesterol，TC）、血浆纤维蛋白原（plasma fibrinogen，FIB）、血液黏度（blood viscosity，PV）及不良反应发生情况。结果 治疗后，观察组临床总有效率明显高于对照组（87.04%vs 68.63%）（P<0.05）；观察组CD4⁺和CD4⁺/CD8⁺水平明显高于治疗前和对照组，CD8⁺明显低于对照组（P<0.05）；观察组血清ALB明显高于治疗前和对照组，而24 h尿蛋白定量、Scr、BUN水平明显低于治疗前和对照组；观察组血清TG、TC、FIB及PV水平明显高于对照组（P<0.05）；观察组总不良反应发生率明显低于对照组（5.56%vs 19.61%）（P<0.05）。结论 肾病综合征患者予以他克莫司治疗，不仅可显著提高临床疗效，还可改善T淋巴CD4⁺、CD8⁺、CD4⁺/CD8⁺细胞水平及血脂相关水平，且安全性高，利于肾功能恢复，临床应用价值高。

Abstract:

OBJECTIVE To explore the clinical effect of tacrolimus on nephrotic syndrome and its influence on T lymphocyte subsets. METHODS A total of 105 patients with nephrotic syndrome admitted to Xingtai People's Hospital from December 2017 to December 2019 were selected as study subjects, and were divided into observation group(n=54) and control group(n=51) according to the random number table method. The control group was treated with prednisone tablet, while the observation group was treated with tacrolimus. The clinical treatment effect, T lymphocyte subsets, renal function indicators serum creatinine(Scr), blood urea nitrogen(BUN), serum albumin(ALB), 24 h urinary protein quantitative, serum triacylglycerol(TG), total cholesterol(TC), plasma fibrinogen(FIB), blood viscosity(PV) and adverse reactions were compared between the two groups. RESULTS After treatment, the total clinical effective rate of the observation group was significantly higher than that of the control group(87.04% vs 68.63%)(P<0.05). The levels of CD4⁺ and CD4⁺/CD8⁺ in the observation group were significantly higher than those before treatment and the control group, and CD8⁺ was significantly lower than that in the control group(P&llt;0.05). In the observation group, serum ALB was significantly higher than that before treatment and control group, while urinary protein quantification, Scr, BUN levels were significantly lower than that before treatment and control group(P<0.05). The levels of TG, TC, FIB and PV in the observation group were significantly higher than those in the control group(P<0.05). The total adverse reaction rate in the observation group was significantly lower than that in the control group (5.56% vs 19.61%)(P<0.05). CONCLUSION Tacrolimus treatment in patients with nephrotic syndrome can not only significantly improve the clinical efficacy, but also improve the level of T lymphocyte CD4⁺, CD8⁺, CD4⁺/CD8⁺ cells and blood lipid-related levels. It is safe, beneficial to the recovery of renal function and has high clinical value.