国际医药卫生导报 ›› 2023, Vol. 29 ›› Issue (2): 207-.DOI: 10.3760/cma.j.issn.1007-1245.2023.02.015

• 科研课题专栏 • 上一篇    下一篇

他克莫司联合阿魏酸哌嗪对肾病综合征患儿肾功能及凝血功能的影响

栾海燕1  田巧焕1  王聪2   

  1. 1聊城市第三人民医院儿科,聊城 2520002山东省立医院儿科,济南 250021

  • 出版日期:2023-01-15 发布日期:2023-01-30
  • 通讯作者: 栾海燕,Email:mmm13869521318@163.com
  • 基金资助:

    山东省自然科学基金青年项目(ZR2021QH223

Effects of tacrolimus combined with piperazine ferulate on renal function and blood coagulation in children with nephrotic syndrome

Luan Haiyan1, Tian Qiaohuan1, Wang Cong2   

  1. 1 Department of Pediatrics, Liaocheng Third People's Hospital, Liaocheng 252000, China; 2 Department of Pediatrics, Shandong Provincial Hospital, Jinan 250021, China

  • Online:2023-01-15 Published:2023-01-30
  • Contact: Luan Haiyan, Email: mmm13869521318@163.com
  • Supported by:

    Youth Project of Natural Science Fund in Shandong (ZR2021QH223)

摘要:

目的 探讨他克莫司联合阿魏酸哌嗪对肾病综合征(NS)患儿肾功能及凝血功能的影响。方法 选取聊城市第三人民医院20191月至202012月肾病内科收治的61NS患儿为研究对象,随机数字表法分为对照组30例、研究组31例。对照组:男12例、女18例,年龄1105.61±1.35)岁;研究组:男15例、女16例,年龄1115.52±1.28)岁。对照组给予阿魏酸哌嗪治疗,研究组给予他克莫司联合阿魏酸哌嗪治疗。比较两组患儿临床疗效及治疗前后肾功能[血肌酐(Scr)、尿素氮(BUN)、24 h尿蛋白定量]、凝血功能[凝血酶原时间(PT)、纤维蛋白原(FIB)、D-二聚体(D-D)]、免疫功能[免疫球蛋白(IgAIgGIgM]、肾小管损伤指标[尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、肾损伤因子(KIM-1)]水平及不良反应发生情况,组间比较采用独立样本t检验、χ2检验。结果 研究组总有效率为90.32%28/31),高于对照组的70.00%21/30),两组比较,差异有统计学意义(P<0.05)。治疗后,研究组24 h尿蛋白定量、ScrBUNFIBD-DNGALKIM-1水平低于对照组,PTIgAIgGIgM高于对照组(均P<0.05)。研究组不良反应发生率为19.35%6/31),与对照组的16.67%5/30)比较,差异无统计学意义(P>0.05)。结论 他克莫司联合阿魏酸哌嗪治疗NS患儿疗效确切且安全性高,可改善肾功能、凝血功能,调节免疫功能,降低肾小管损伤指标的表达水平。

关键词:

肾病综合征, 他克莫司, 阿魏酸哌嗪, 肾功能, 凝血功能

Abstract:

Objective To investigate the effects of tacrolimus combined with piperazine ferulate on renal function and coagulation in children with nephrotic syndrome (NS). Methods Sixty-one children with NS admitted to Department of Nephrology, Liaocheng Third People's Hospital from January 2019 to December 2020 were selected for the study and divided into in a control group (30 cases) and a study group (31 cases) by the random number table method. There were 12 boys and 18 girls in the control group who were 1-10 (5.61±1.35) years old. There were 15 boys and 16 girls in the study group who were 1-11 (5.52±1.28) years old. The control group were treated with piperazine ferulate, and the study group with tacrolimus and piperazine ferulate. The clinical efficacies and renal function [blood creatinine (Scr), urea nitrogen (BUN), 24 h urine protein quantification], coagulation function [prothrombin time (PT), fibrinogen (FIB), D-dimer (D-D)], immune function [immunoglobulin A (IgA), immunoglobulin G (IgG), immunoglobulin M (IgM)], and renal tubular injury indicators [urinary neutrophil gelatinase-associated lipid transport protein (NGAL), kidney injury factor (KIM-1)] before and after the treatment and incidences of adverse reactions were compared between the two groups by independent-sample t test and χ2 test. Results The total effective rate in the study group was higher than that in the control group [90.32% (28/31) vs. 70.00% (21/30)], with a statistical difference (P<0.05). After the treatment, the levels of 24 h urine protein quantification, Scr, BUN, FIB, D-D, NGAL, and KIM-1 were lower and the PT and levels of IgA, IgG, and IgM were higher in the study group than in the control group (all P<0.05). There was no statistical difference in the incidence of adverse reactions between the study group and the control group [19.35% (6/31) vs. 16.67% (5/30); P>0.05]. Conclusion Tacrolimus combined with piperazine ferulate is effective and safe in treating children with NS and can improve their renal function and coagulation, regulate their immune function, and reduce the expression levels of renal tubular injury indicators.

Key words:

Nephrotic syndrome, Tacrolimus, Piperazine ferulate, Renal function, Coagulation