| 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 case information and treatment with tacrolimus(TAC)and morphomycolipid(MMF)were selected as the research 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(serum albumin and alanine aminotransferase),blood lipids(triglycerides and Total cholesterol),renal function(blood creatinine,blood urea nitrogen,cystatin C and ?2 microglobulin),immune indicators(Ig G,Ig M,Ig A,CD4+,CD8+,CD19+,CD4+ / CD8+ ratio),etc.Symptoms evaluated the effective rate and incidence of adverse reactions in both groups.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 significant differences in urinary red blood cell counts,24 h 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 24 h urinary protein quantification in the two groups were significantly lower than those 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 serum albumin at 1 month after treatment were not statistically significant compared with those before treatment(P>0.05),and the serum albumin in both groups increased 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 aminotransferase compared with before treatment(P>0.05);6.The blood creatinine,blood urea nitrogen,serum cystatin C,and ?2 microglobulin in the two groups decreased after treatment for 3 and 6 months(P<0.05);7.Ig G in the two groups increased compared with that before treatment at 1,3,and 6 months after treatment(P<0.05).Ig A and Ig M in the two groups decreased 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 adverse reactions in group B was significantly higher than that in group A(P<0.05).Conclusions:1.TAC and MMF have a better effect on children with HSPN,TAC has better effect than MMF,and TAC has fewer adverse reactions than MMF.2.TAC and MMF both regulate immune function.There is no significant difference between the two in regulating humoral immunity.TAC regulates cellular immune function better than MMF. |
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