Search

Objective:To observe the efficacy of triple regimen of tacrolimus combined with low--dose glucocorticoid and low-dose sirolimus in treatment of children with steroid -resistant nephrotic syndrome. Methods: Sixty children with steroid-resistant nephrotic syndrome admitted for treatment in the Hainan Women and Childrens Medical Center from January 2018 to January 2019 were selected as study subjects, and were randomly divided into the triple regimen group and the double regimen group, each consisting of 30 patients. The patients in the triple regimen group received tacrolimus combined with low-dose glucocorticoid and low-dose sirolimus, while the patients in the double regimen group just received tacrolimus combined with low - dose glucocorticoid. After 3,6 and 12 months of treatment, renal function, blood lipid levels and therapeutic effects were observed and adverse drug reactions (ADRs) and relapse in 2 years were compared between the 2 groups. Results: No statistical significance could be seen in glomerular filtration rate, corrected creatinine clearance (CCr), 24 h urine protein and total cholesterol, when comparisons were made between the 2 groups before treatment and 3 months after treatment (P>0. 05). After 6 and 12 months of treatment, the total cholesterol and 24 h urine protein in the triple regimen group were lower than those in the double regimen group, and the glomerular filtration rate and CCr in the former were higher than those in the latter, with statistical significance (PC0.05). After 6 months of treatment, there was no statistical significance in the total remission rate, when comparisons were made between the two groups (93.33% vs 80.00% f PO.05). After 12 months of treatment, the remission rate of the triple regimen group was significantly higher than that of the double regimen group (90.OCM vs 66.67%, 0.05). During treatment, there was no statistical significance in the rate of ADRs, when comparisons were made between the two groups (P>0. 05). The 2-year relapse rate of the triple regimen group was significantly lower than that of the double regimen group (10.0(M vs 36.67%, P