Efficacy of tacrolimus,mycophenolate mofetil combined with glucocorticoid in treating renal damage in anti-neutrophil cytoplasmic antibody-associated vasculitis
Objective To compare the efficacy of tacrolimus(TAC),mycophenolate mofetil(MMF)combined with glucocorticoid in treating renal damage in anti-neutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV).Methods 80 patients with AAV who were accepted by the hospital were gathered,and the random number table method was used as the basis for grouping.Group A(n=41)received TAC combined with glucocorticoid therapy.Group B(n=39)received MMF combined with glucocorti-coid therapy.ANCA,Birmingham vasculitis activity score(BVAS),renal function,vascular endothelial function-related indexes,cellular immune indexes and adverse reactions were compared between the 2 groups.Results Compared with before treatment,the ANCA,BVAS,24-hour urinary protein quantification(24-h UPQ),blood urea nitrogen(BUN),cystatin C(CysC),soluble fms-like tyrosine kinase-1(SFlt-1),lysosome-associated membrane protein-2(LAMP-2)antibody,and vascular endothelial growth factor(VEGF)after treatment in the 2 groups were decreased(P＜0.05),and group A were lower than group B(P＜0.05).After treatment,the CD4+ of the 2 groups was increased(P＜0.05),and CD8+ and CD19+ were decreased(P＜0.05),the CD4+ of group A was higher than group B(P＜0.05),the CD8+ and CD19+ of group A were lower than group B(P＜0.05).The total incidence of adverse reactions in group A(9.76%)was lower than that in group B(28.21%)(P＜0.05).Conclusion Compared with MMF combined with glucocorticoid therapy,TAC combined with glucocorticoid in the treatment of AAV renal damage is more effective in reducing serum ANCA value,reducing BVAS,improving renal function,protecting vascular endothelial function,and regulating cellular immunity,with high security.
NETL
NSTL
万方数据
维普
