陶主任他克莫司在肾小球疾病中的应用20110814.pptVIP

* * 他克莫司起始剂量: 0.1-0.2mg/kg/d 谷浓度为3-8ng/mL 强的松起始剂量30mg/d，每2周减5mg直至20mg/d，然后每4周减5mg直至10mg/d；此后每4周减2.5mg至5mg/d维持 6个月后停用他克莫司改为激素＋AZA（1.5mg/kg/d）维持治疗 * 通讯作者：黎磊石。作者单位：南京大学医学院附属金陵医院（南京军区总院）肾病研究所 * 参考文献： 沈淑琼，黎磊石，胡伟新，等。普乐可复诱导治疗弥漫增生性狼疮性肾炎疗效的影响因素分析。肾脏病与透析肾移植杂志，2005， 14（3） 刘玉春，赵明辉，邹万忠，等。普乐可复治疗弥漫增生性狼疮性肾炎5例临床病理观察。中国实用内科杂志，2004，24（3） Chi Chiu Mok, Ka Hang Tong, Chi Hung To, et al. Kidney international, 2005, 68: 813-7. 陈强，刘志红，胡伟新，等。普乐可复治疗Ⅳ型狼疮性肾炎的前瞻性临床研究。肾脏病与透析肾移植杂志，2002， 11（4） 陈强，刘志红，胡伟新，等。他克莫司联合激素治疗Ⅴ型狼疮性肾炎的疗效。肾脏病与透析肾移植杂志，2004， 13（2） 鲍浩，章海涛， 张馨，等。难治性狼疮性肾炎多靶点治疗前瞻性临床研究。肾脏病与透析肾移植杂志，2007， 16（1） Insomnia 失眠症 emotional * * TH-PO237] Clinical Analysis of Tacrolimus Therapy Versus Intermittent Cyclophosphamide Pulse Treatment in Lupus NephritisLihui Qu, Suya Wang, Jianghua Chen The Kidney Disease Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, ChinaOBJECTIVE Although cyclophosphamide (CYC) had thought to be the preferred initial treatment, their usage was limited by side effects and high relapse rate. Preliminary studies have shown that tacrolimus (FK506) is effective in the treatment of lupus nephritis, but the clinical experience still remains a little. In this open-labeled pilot study, the clinical efficacy and survival between FK506 and pulse cyclophosphamide (CYC) therapy in lupus nephritis were compared. METHODOLOGY Thirty eight patients with active lupus nephritis were treated by FK506 or pulse CYC therapy. 20 cases were given FK506 at a dosage of 0 .1mg/ (kgd) and oral prednisone (FK506 Group). Another 18cases were given oral prednisone, pulse therapy with CYC (0.751.0g/ m2 BSA) was given monthly for 6months and then quarterly (CYC Group). Patients in two groups were comparable in age, sex distribution and severity of renal damage. All patients were treated for more than 12 months. The clinical security and validity and survival were compared between the two groups. RESULTS Clinical efficacy after 12 months:FK506 therapy wa