| Systemic lupus erythematosus(SLE) is a systemic multiple organ system, many small blood vessels and connective tissue diseases, the incidence rate of 50-70 / 100000, is a common disease to harm people’s health. Lupus nephritis(LN) is a common complication of systemic lupus erythematosus, accounting for about 13.12% of kidney disease, secondary kidney disease leading to end stage renal failure common etiology, approximately 5% of patients with LN ~ 20% in 10 years developed into uremia. In recent years, with the development of application of cytotoxic drugs and glucocorticoids in clinic, especially a variety of new immunosuppressant inventions, LN has a certain improvement in treatment.Tacrolimus(FK506) is a new type of calcineurin inhibitors, has been reported in the literature of tacrolimus can inhibit the generation of IL-2 and T cell activation. It can play a unique immune inhibition by cyclosporine sensitive pathway, activation can inhibit the initial T cells, and can inhibit the activation and proliferation of sensitized T cells, the inhibition of T cell activation effect than cyclosporine a strong 10- 100 times; in addition, tacrolimus can significantly inhibit the production of Th2 by IL-10 to reduce the B cells produce autoantibodies. The treatment has been gradually applied to LN induction period in recent years.Cyclophosphamide(CTX) is a cell cycle non-specific alkylating agent, which is mainly blocked rapidly dividing cells in S phase, G0 phase of resting cells have the function; can inhibit T and B lymphocytes proliferation; can also inhibit lymphoblastoid cell in response to antigenic stimulation; reduce serum immunoglobulin levels, thereby reducing the antibody and immunoglobulin production; immunosuppressive effect of strong and durable, and anti-inflammatory effect is weak. As the first-line drug, can control the activity of LN, reduce the amount of hormone, prevent kidney fibrosis.This study of new immunosuppressive therapy for LN is increasing, the purpose of this paper is to observe and study of tacrolimus and cyclophosphamide plus glucocorticoids in patients with lupus nephritis curative effect and safety.Objective: To investigate the tacrolimus and cyclophosphamide plus glucocorticoids in patients with lupus nephritis curative effect and safety.Methods: select 180 cases of lupus nephritis patients admitted to the Department of rheumatism of Affiliated Hospital of Jining Medical College, were randomly divided into observation group and control group two groups, 90 cases in each group. Patients in control group were treated with prednisone plus intermittent cyclophosphamide pulse therapy, observation group were treated with tacrolimus and prednisone, compared two groups of patients were the observed indexes, therapeutic effect and adverse reaction.Results: the patients in the observation group treatment effect(total effective rate 88.00%) was better than the control group patients(the total efficiency of 68.00%), and the rate of adverse reaction was observed(the total incidence rate of 12.00%) than the control group(the total incidence rate 24.00%), statistically significant difference, P<0.05.Conclusion: Tacrolimus, cyclophosphamide in the treatment of LN can effectively control the disease, but the Tacrolimus better curative effect, less side effect, more safety. |
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