Clinical Observation of Enhanced Immunosuppressive Therapy in the Treatment of Refractory Nephrotic Syndrome
10.6039/j.issn.1001-0408.2017.23.19
- VernacularTitle:强化免疫抑制方案治疗难治性肾病综合征的临床观察
- Author:
Tianli SHI
;
Zhen LUO
;
Shi JIAO
- Keywords:
Enhanced immunosuppressive therapy;
Immunosuppressive agent;
Refractory nephrotic syndrome;
Glucocorti-coids;
Leflunomide;
Mycophenolate mofetil;
Renal function;
Recurrence risk;
ADR
- From:
China Pharmacy
2017;28(23):3237-3240
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To observe the clinical efficacy and safety of enhanced immunosuppressive therapy in the treatment of refractory nephrotic syndrome (RNS). METHODS:Totally 76 RNS patients were selected from 2 hospitals during Jan. 2012-Mar. 2015,and then divided into control group and observation group according to random number table,with 38 cases in each group. Two groups were given Prednisone acetate tablet 50 mg,qd;decreasing to 15 mg,qd,after urine protein returned to normal. Based on it,control group was given Leflunomide tablets 50 mg,qd;decreasing to 20 mg,qd,3 days later. Based on con-trol group,observation group was additionally given Mycophenolate mofetil dispersible tablet 750 mg,bid;decreasing to 500 mg, qd,3 months later. Both groups were treated for 6 months. Clinical efficacies,follow-up recurrence rate as well as renal function in-dexes and inflammatory cell factors before and after treatment,and the occurrence of ADR were compared between 2 groups. RE-SULTS:The total response rate of observation group(92.11%)was significantly higher than control group(73.68%),and fol-low-up recurrence rate(5.26%)was significantly lower than control group(23.68%),with statistical significance(P<0.05). Be-fore treatment,there was no statistical significance in renal function indexes or inflammatory cell factors between 2 groups(P>0.05). After treatment,24 h urinary protein quantification,urinary IL-6 and IL-8 levels of 2 groups decreased significantly,while the content of serum protein increased significantly;the observation group was significantly better than the control group,with sta-tistical significance(P<0.05). There was no statistical significance in the content of serum creatinine between 2 groups before and after treatment(P>0.05). The incidence of ADR in the control group and the observation group was 34.21% and 44.74% respec-tively,without statistical significance between 2 groups(P>0.05). CONCLUSIONS:Enhanced immunosuppressive therapy in the treatment of RNS can improve renal function,reduce inflammatory reaction and long-term recurrence risk,and have good therapeu-tic efficacy and safety.
