目录
绿色照片中文摘要 (1)郑强语录
英文摘要 (3)
英文缩写 (6)
研究论文他克莫司与吗替麦考酚酯治疗儿童紫癜性肾炎疗效及安全性对比研究
前言 (7)隶书对联
材料与方法 (9)
结果 (11)
讨论 (22)
结论 (26)
参考文献 (27)
综述儿童紫癜性肾炎治疗进展 (32)
群禁言在哪里设置致谢 (43)
个人简历 (44)
他克莫司与吗替麦考酚酯治疗儿童紫癜性肾炎疗效及安全性对
比研究
摘要
目的：探讨他克莫司与吗替麦考酚酯治疗儿童紫癜性肾炎的疗效及安全性。
方法：
选取我院2015年1月-2019年1月住院期间，病例资料完整、分别应用他克莫司(TAC)及吗替麦考酚酯(MMF)治疗的93例患儿作为研究对象。按照治疗方案不同分为A组(n=49)和B组(n=44)，其中A组给予足量激素联合口服TAC治疗，B组给予足量激素联合口服MMF治疗。分别监测两组治疗前，治疗后1、3、6个月的尿红细胞计数、24小时尿蛋白、补体C3、补体C4、肝功能(血清白蛋白和谷丙转氨酶)、血
脂(甘油三酯和总胆固醇)、肾功能(血肌酐、血尿素氮、胱抑素C和β2微球蛋白)、免疫指标(IgG、IgM、IgA、CD4+、CD8+、CD19+、CD4+/CD8+比值)等，通过监测以上指标及患儿临床症状评价两组的有效率及不良反应发生率。
结果：1.两组年龄、性别、临床分型、病理分级及肾外累及症状比较，差异均无统计学意义(P>0.05)；2.治疗前两组尿红细胞计数、24h尿蛋白定量、血脂、肝功能、肾功能、补体C3、补体C4、免疫指标比较差异无统计学意义(P>0.05)；3.两组尿红细胞计数及24h尿蛋白定量在治疗后1、3、6个月均较治疗前明显降低，差异有统计学意义(P<0.05)；4.两组治疗后1、3、6个月总胆固醇较治疗前降低，差异有统计学意义(P<0.05)，治疗后3、6个月两组甘油三酯较治疗前明显降低，差异有统计学意义(P<0.05)；5.两组治疗后1个月血清白蛋白变化较治疗前无统计学意义(P>0.05)，治疗后3个月、6个月两组血清白蛋白较治疗前均有所上升(P<0.05)；两组谷丙转氨酶治疗后1、3、6个月较治疗前比较，差异无统计学意义(P>0.05)；6.治疗后3、6个月两组血肌酐、血尿素氮、血胱抑素C和β2微球蛋白均较治疗前下降，差异有统计学意义(P<0.05)；
7.治疗后1、3、6个月两组IgG较治疗前比较均上升(P<0.05)；治疗后6个月两组IgA、IgM较治疗前均有所降低，差异有统计学意义(P<0.05)；
8.治疗后1、3、6个月两组CD8+、CD19+、 CD4+/CD8+较治疗前比较，差异有统计学意义(P<0.05)；
治疗后3、6个月两组CD4+均较治疗前升高，差异有统计学意义(P<0.05)；9.治疗后1、3、6个月两组的补体C4较治疗前比较差异无统计学意义(P>0.05)；治疗后3、6个月两组补体C3较治疗前升高，差异有统计学意义(P<0.05)；10.A组治疗后3、6个月总有效率均较B组高，两者之间差异存在统计学意义(P<0.05)；且B组总不良反应发生率显著高于A组(P<0.05)。
翁贝托二世结论：
1.TAC与MMF治疗儿童HSPN均具有较好疗效，TAC较MMF疗效更显著，且TAC不良反应较MMF少。
2.TAC及MMF均有调节免疫作用，两者调节体液免疫比较无明显差异，TAC调节细胞免疫作用较MMF更显著。
关键词：紫癜性肾炎，儿童，他克莫司，吗替麦考酚酯
移动短信查话费Comparison of efficacy and safety of tacrolimus and morphocolipate in children with Henoch-Schonlein purpuric
nephritis
ABSTRACT
经典古言小说Objective：To investigate the efficacy and safety of tacrolimus and morphocolipate in the treatment of Henoch-Schonlein purpuric nephritis in children.
Methods:
During the period of hospitalization from January 2015 to January 2019 in our hospital, 93 children with complete ca information and treatment with tacrolimus (TAC) and morphomycolipid (MMF) were lected as the rearch subjects. According to different treatment schemes, they were divided into group A (n=49) and group B (n=44), group A was given a sufficient amount of hormone combined with oral TAC, and group B was given a sufficient amount of hormone combined with oral MMF. Urine red blood cell counts, 24-hour urine protein, complement C3, complement C4, liver function (rum albumin and alanine aminotransfera), blood lipids (triglycerides and Total cholesterol), renal function (blood creatinine, blood urea nitrogen , cystatin C and β2 microglobulin), immune indicators (IgG, IgM, IgA, CD4+, CD8+, CD19+, CD4+ / CD8+ ratio), etc. Symptoms evaluated the effective rate and incidence of adver reactions in both groups.生产批号是生产日期吗
Results:1.There was no significant difference in age, gender, clinical classification, pathological grade, and extrarenal involvement symptoms between the two groups (P>0.05); 2.There were no sig
nificant differences in urinary red blood cell counts, 24h urinary protein quantification, blood lipids, liver function, renal function, complement C3, complement C4, and Immune indicators before treatment between the two groups (P>0.05); 3.The urinary
red blood cell count and 24h urinary protein quantification in the two groups were significantly lower than tho before treatment at 1, 3, and 6 months after treatment, and the differences were statistically significant (P<0.05); 4. Total cholesterol in the two groups was lower than that before treatment at 1, 3, and 6 months after treatment, and the difference was statistically significant (P<0.05);Triglyceride was significantly lower in the two groups at 3 and 6 months after treatment than before the difference was statistically significant (P<0.05). 5.The changes in rum albumin at 1 month after treatment were not statistically significant compared with tho before treatment (P>0.05), and the rum albumin in both groups incread at 3 and 6 months after treatment compared with before treatment (P<0.05); there was no significant difference between the two groups at 1, 3, and 6 months after treatment with alanine aminotransfera compared with before treatment (P>0.05); 6.The blood creatinine, blood urea nitrogen, rum cystatin C, and β2 microglobulin in the two groups decread after treatment for 3 and 6 months (P<0.05); 7.IgG in the two groups incread compared with that before treatment at 1, 3, and 6 months after treatment (P<
0.05). IgA and IgM in the two groups decread after treatment at 6 months after treatment, with differences statistical significance (P<0.05); 8.The difference between CD8+, CD19+, CD4+/ CD8+ in the two groups at 1 month, 3 months and 6 months after treatment was statistically significant (P<0.05); CD4+ in the group was higher than that before treatment, and the difference was statistically significant (P<0.05);
9.There was no significant difference in complement C4 between the two groups at 1, 3, and 6 months after treatment (P > 0.05). The complement C3 of the two groups at 3 and 6 months after treatment was higher than before treatment, and the differences were statistically significant (P<0.05); 10.The total effective rate of group A was higher than that of group B at 3, and 6 months after treatment, and the difference was statistically significant (P<0.05); and the incidence of adver reactions in group B was significantly higher than that in group A (P<0.05).
