他克莫司联合激素、低分子肝素治疗难治性肾病综合征的疗效观察

目的 观察他克莫司( Tacrolimus,TL)联合激素、低分子肝素治疗难治性肾病综合征的疗效.方法 10例原发性肾病综合征患者,24小时蛋白尿≥6 g至少3个月,激素治疗无效或激素依赖,快速撤减激素至0.5mg/( kg·d),同时给予他克莫司[0.05～0.08mg/ (kg·d)]口服,联合低分子肝素治疗,每2周复查24小时尿蛋白、血浆白蛋白、TG、TC水平.结果 10例患者中完全缓解6例,部分缓解3例,无效1例,无恶化病例,无严重不良反应发生.结论 他克莫司联合激素、低分子肝素治疗难治性肾病综合征患者能显著改善蛋白尿,提高缓解率,有效缩短缓解时间,减少肾功能恶化的风险,且较为安全.

The efficacy of tacrolimus combining hormones,low molecular weight heparin in the treatment of refractory nephrotic syndrome

Objective To observe efficacy of tacrolimus combining hormones,low molecular weight heparin in the treatment of refractory nephrotic syndrome.Methods 10 cases of primary nephrotic syndrome,which are 24-hour proteinuria ≥ 6 g at least 3 months,and with ineffective hormone therapy or hormone-dependent.To rapidly withdrawal prednisone to 0.5 mg/kg before the study,while giving tacrolimus [0.05 ～ 0.08mg /(kg·d)]orally,gradually reduced it,and combined with low molecular weight heparin,review every 2 weeks 24h urine protein,serum albumin,TG,TC levels.Results In the group of 10 patients,complete remission in 6 cases,partial remission in 3 cases,ineffective in 1 cases,deterioration in 0 cases,no serious adverse events.Conclusion Tacrolimus combined hormones,low molecular weight heparin in the treatment of refractory nephrotic syndrome patients were significantly improved proteinuria,improve response rates,shorten remission time,significantly reduce the risk of worsening renal function,and safe.