Di Jia, Qian Qing, Yang Min, Jiang Yaping, Zhou Hua, Li Min, Zou Yun
Department of Nephrology, The First People's Hospital of Changzhou, Changzhou, Jiangsu 213003, P.R. China.
Department of Pharmacy, The First People's Hospital of Changzhou, Changzhou, Jiangsu 213003, P.R. China.
Exp Ther Med. 2018 Aug;16(2):979-984. doi: 10.3892/etm.2018.6211. Epub 2018 May 23.
The aim of the present study was to observe the efficacy and safety of long-course treatment with tacrolimus combined with low-dose corticosteroids for idiopathic membranous nephropathy (IMN). A total of 76 patients with IMN diagnosed by renal biopsy between March 2012 and January 2016 form The First People's Hospital of Changzhou (Changzhou, China) were selected and randomly divided into a short-course group and a long-course group (each, n=38). Patients in the short-course group were treated with hormone combined with tacrolimus for 12 months, whereas those in the long-course group received the same treatment for 24 months. The efficacy, safety and recurrence of the two groups of patients were observed, and serum ALB, urine protein, Scr and blood glucose were assessed once a month for 24 months by measuring blood biochemistry. A total of 11 patients exhibited adverse effects, 6 of whom were serious and as such were excluded from the study. In the short-course group, 8 of 35 patients demonstrated complete remission (CR), 17 patients exhibited partial remission (PR) and the remaining 10 patients had no remission (NR); however the disease recurred in 8 patients following treatment. In the long-course group, 16 of 35 patients exhibited CR, 14 patients demonstrated PR and the remaining 5 patients had NR. Furthermore, the disease recurred in 4 patients following treatment. Significant differences were observed in urine protein and serum ALB at 18 and 24 months following treatment between the two groups while Scr and blood glucose had no significant differences at any time point. It was concluded that long-course tacrolimus combined with low-dose hormone effectively treats idiopathic membranous nephropathy and that therapy demonstrated a relatively high remission rate, and the recurrence rate of the disease is low.
本研究旨在观察他克莫司联合小剂量糖皮质激素长疗程治疗特发性膜性肾病（IMN）的疗效和安全性。选取2012年3月至2016年1月期间在常州市第一人民医院（中国常州）经肾活检确诊为IMN的76例患者，随机分为短疗程组和长疗程组（每组n = 38）。短疗程组患者接受激素联合他克莫司治疗12个月，而长疗程组患者接受相同治疗24个月。观察两组患者的疗效、安全性和复发情况，并通过检测血液生化指标，在24个月内每月评估一次血清白蛋白、尿蛋白、Scr和血糖。共有11例患者出现不良反应，其中6例严重，因此被排除在研究之外。短疗程组35例患者中，8例完全缓解（CR），17例部分缓解（PR），其余10例未缓解（NR）；然而，8例患者治疗后疾病复发。长疗程组35例患者中，16例CR，14例PR，其余5例NR。此外，4例患者治疗后疾病复发。两组治疗后18个月和24个月时尿蛋白和血清白蛋白有显著差异，而Scr和血糖在任何时间点均无显著差异。结论是他克莫司联合小剂量激素长疗程有效治疗特发性膜性肾病，该疗法缓解率较高，疾病复发率较低。
