RESUMO
Objective To evaluate the effects and safety of tarcrolimus on children difficult nephritic syndrome.Methods Databases including the Cochrane Library,Pubmed,Medline,OVID,CNKI,Wan Fang Data and VIP were searched to collect the controlled trials on tacrolimus capsule published from Jan 2003 to Jun 2013.The quality of the included randomized controlled trials was assessed by Jadad,and the complete remission,the fail,the relapsing rate of 12 month and side effects after treatment were extracted,meta-analysis was performed using RevMan 5.0 software.Results Among 179 articles,6 articles were included,4 of them were English and the other 2 were Chinese.The results of meta-analysis based on stratified therapeutic strategies showed that:(1) comparing with cyclophosphamide,tacrolimus could decrease the fail and relapsing rate of 12 month,but could not increase the complete remission (P ＞ 0.05).(2) Comparing with cyclosporine A,tacrolimus had no difference in complete remission and the relapsing rate of 12 month (P ＞ 0.05),but could decrease the fail.(3) Tacrolimus could increase the complete remission and decrease fail,but had no difference in relapsing rate (P ＞ 0.05).(4) There was no significant difference in relapsing rate between tacrolimus and rituximab(P ＞ 0.05).(5) Tacrolimus had less side effects than cyclophosphamide.Conclusion Tacrolimus have advantages to cyclophosphamide,cyclosporine A and prednisolone,but not to rituximab,and have less side effects than cyclophosphamide.