他克莫司治疗儿童激素抵抗型肾病综合征研究进展

摘要

激素抵抗型肾病综合征(SRNS)是儿童原发性肾病综合征中治疗相对棘手的一种临床类型,目前治疗上主要是应用激素和免疫抑制剂的联合治疗.临床上常用的免疫抑制剂主要包括他克莫司、环孢素、环磷酰胺、霉酚酸酯等,其中他克莫司诱导的临床缓解率优于其他免疫抑制剂,已经成为治疗SRNS的一线用药.他克莫司的药物代谢个体差异性大,需要定期检测患儿的血药浓度.为获得他克莫司最优的疗效,减少其肾毒性,推荐SRNS患儿使用小剂量、长疗程的治疗方案.%Steroid-resistant nephrotic syndrome (SRNS) is a relatively difficult clinical type of treatment.The major therapy measures in present include steroid and immunosuppressant.Commonly used immunosuppressant include tacrolimus,cyclosporin,cyclophosphamide,mycophenolate mofetil,ect.Tacrolimus-induced clinical remission rate is superior to other immunosuppressive agents,has been the first-line agent of SRNS.Because of the individual difference in metabolism,the drug concentration of tacrolimus should be determined periodically.In order to obtain optimal efficacy of tacrolimus and reduce renal toxicity,the treatment protocols of small doses with long courses for children with SRNS were recommended.