Jiang Wei, Li Xianping, Liu Xiaoming, Zhang Chi, Lu Guoyuan, Yang Jiangang, Qiao Li, Bai Yu, Zhou Changle, Niu Qiuya, Luo Qing, Zhong Wanxin, Kong Fancheng, Zhou Wanping, Yin Cuoji, Tang Weigang, Xu Wei
Department of Nephrology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China.
Department of Nephrology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China.
Medicine (Baltimore). 2025 Jul 18;104(29):e43358. doi: 10.1097/MD.0000000000043358.
This systematic review studied and compared the safety and efficacy of glucocorticoids (GCs) + cyclophosphamide (CTX) and GCs + tacrolimus (TAC) therapies for treating children with Henoch-Schönlein purpura nephritis (HSPN).
The data on GCs + CTX and GCs + TAC therapies for HSPN children were procured from the EMbase, China National Knowledge Infrastructure, the Cochrane Library, PubMed, and Wanfang from the inception to May 10, 2024.
This review included 5 studies (2 non-randomized and 3 randomized controlled trials), comprising 363 patients. Furthermore, the complete remission within 6 months in the TAC group (43.3%) was higher than that in CTX group (26.2%) and the total remission within 6 months in the TAC (76.7%) was higher than that in CTX groups (54.1%). Moreover, in terms of adverse reactions, the incidence of hypertension in TAC group was higher than that in CTX group, whereas the incidences of other adverse reactions such as liver function injury, hyperglycemia, myelosuppression and gastrointestinal discomfort in TAC group were lower than that in CTX group.
This systematic review indicated that for HSPN children, the TAC therapy may have relatively higher remission rate and fewer adverse reactions than the CTX therapy.
本系统评价研究并比较了糖皮质激素（GCs）+环磷酰胺（CTX）与GCs+他克莫司（TAC）治疗儿童过敏性紫癜性肾炎（HSPN）的安全性和有效性。
从EMbase、中国知网、考克兰图书馆、PubMed和万方数据库中检索自建库至2024年5月10日有关GCs+CTX和GCs+TAC治疗HSPN儿童的数据。
本评价纳入5项研究（2项非随机研究和3项随机对照试验），共363例患者。此外，TAC组6个月内的完全缓解率（43.3%）高于CTX组（26.2%），TAC组6个月内的总缓解率（76.7%）高于CTX组（54.1%）。而且，在不良反应方面，TAC组高血压的发生率高于CTX组，而TAC组肝功能损伤、高血糖、骨髓抑制和胃肠道不适等其他不良反应的发生率低于CTX组。
本系统评价表明，对于HSPN儿童，TAC治疗可能比CTX治疗具有相对更高的缓解率和更少的不良反应。
