Li Lu, Du Yong, Ji Juan, Gao Ying, Shi Xiao-Qiang
Lu Li, Department of Nephrology, Baoding First Hospital, Baoding 071000, Hebei, P.R. China.
Yong Du, Department of Rheumatology and immunology, Affiliated Hospital of Hebei University, Baoding 071000, Hebei, P.R. China.
Pak J Med Sci. 2022 May-Jun;38(5):1285-1291. doi: 10.12669/pjms.38.5.5117.
To evaluate the safety and efficacy of tacrolimus combined with glucocorticoids in the treatment of lupus nephritis.
A total of 80 patients with lupus nephritis were admitted to the Affiliated Hospital of Hebei University and the First Hospital of Baoding from February 2017 to January 2019 randomly divided into two groups: the experimental group and the control group, with 40 cases in each group. Patients in the experimental group were treated with tacrolimus combined with glucocorticoids, while patients in the control group were treated with cyclophosphamide combined with glucocorticoids for one year. Clinical efficacy and adverse drug reactions were evaluated for all patients after treatment. The changes of CRP, IL-6, 24h urinary protein, serum albumin, serum creatinine, urea nitrogen and other indicators after treatment, as well as the differences in the erythrocyte sedimentation rate (ESR), complement C3, C4, anti-dsDNA antibody positive rate and SLEDAI score and other indicators were also evaluated.
The total efficacy of the experimental group was 92.5%, which was significantly better than the 75% of the control group (p=0.03); The incidence of adverse reactions was 20% in the experimental group and 42.5% in the control group, with a statistically significant difference (p=0.03). After treatment, the levels of CRP, IL-6 and other inflammatory factors in the experimental group were lower than those in the control group, with a statistical significance (p<0.05); The indicators of the experimental group such as 24h urine protein quantification, serum albumin, blood creatinine, and urea nitrogen were improved compared with the control group, with statistically highly significant differences (p<0.001). In addition, ESR, anti-DSDNA antibody positive rate and SLEDAI score were decreased compared with the control group, while complement C3 and C4 levels were significantly increased (p<0.05).
Tacrolimus combined with glucocorticoids is a safe and effective treatment regimen for patients with lupus nephritis, boasting a variety of benefits, such as significant efficacy and fewer adverse reactions. With such a regimen, the level of inflammatory factors can be significantly reduced, renal function indicators can be ameliorated, the ESR, complement C3, C4, anti-dsDNA antibody positive rate and SLEDAI score of the patients can be significantly improved.
评估他克莫司联合糖皮质激素治疗狼疮性肾炎的安全性和有效性。
2017年2月至2019年1月，河北大学附属医院和保定市第一医院共收治80例狼疮性肾炎患者，随机分为两组：实验组和对照组，每组40例。实验组患者接受他克莫司联合糖皮质激素治疗，而对照组患者接受环磷酰胺联合糖皮质激素治疗1年。治疗后评估所有患者的临床疗效和药物不良反应。还评估了治疗后CRP、IL-6、24小时尿蛋白、血清白蛋白、血清肌酐、尿素氮等指标的变化，以及红细胞沉降率（ESR）、补体C3、C4、抗双链DNA抗体阳性率和SLEDAI评分等指标的差异。
实验组总有效率为92.5%，明显优于对照组的75%（p = 0.03）；实验组不良反应发生率为20%，对照组为42.5%，差异有统计学意义（p = 0.03）。治疗后，实验组CRP、IL-6等炎症因子水平低于对照组，差异有统计学意义（p < 0.05）；实验组24小时尿蛋白定量、血清白蛋白、血肌酐、尿素氮等指标较对照组有所改善，差异有高度统计学意义（p < 0.001）。此外，与对照组相比，ESR、抗双链DNA抗体阳性率和SLEDAI评分降低，而补体C3和C4水平显著升高（p < 0.05）。
他克莫司联合糖皮质激素是治疗狼疮性肾炎患者的一种安全有效的治疗方案，具有多种益处，如疗效显著、不良反应较少。采用这种方案可显著降低炎症因子水平，改善肾功能指标，显著提高患者的ESR、补体C3、C4、抗双链DNA抗体阳性率和SLEDAI评分。
