吗替麦考酚酯联合拉米夫定治疗乙型肝炎病毒相关性肾炎  

Clinical Study of Mycophenolate Mofetil and Lamivudine in the Treatment of Hepatitis B Virus Associated Nephritis

作　　者：孙琳琳[1] 吴俊[1] 徐成刚[1] 张黎明[1] 张玉强[1] 梅长林[1] 

机构地区：[1]第二军医大学附属长征医院肾内科

出　　处：《中国中西医结合肾病杂志》2005年第10期584-587,共4页Chinese Journal of Integrated Traditional and Western Nephrology

摘　　要：目的:观察吗替麦考酚酯联合拉米夫定治疗乙型肝炎病毒相关性肾炎(HBV-GN)的疗效,并评价其安全性。方法:13例临床表现为肾病综合征、肾功能正常并经肾活检确诊的HBV-GN患者,给予吗替麦考酚酯联合拉米夫定治疗,观察治疗前后24h尿蛋白定量、血清白蛋白、肝功能(ALT、AST)、肾功能、HBV复制情况(HBeAg、HBV-DNA)以及不良反应。结果:11例患者完成随访。吗替麦考酚酯联合拉米夫定治疗1年总有效率81.8%,其中显效4例(36.4%),有效5例(45.5%)。治疗后尿蛋白较治疗前明显降低,血清白蛋白明显升高(P<0.01)。无1例HBV-DNA滴度进行性增高,无1例肝功能损害。结论:初步观察显示吗替麦考酚酯联合拉米夫定治疗HBV-GN安全有效。Objective：To investigate the clinical efficacy and the adverse effects of mycophenolate mofetil combined with lamivudine in the treatment of patients with hepatitis B virus associated nephritis（HBV - GN）, Methods： 13 patients with HBV GIN diagnosed by kidney biopsy were treated with mycophenolate mofetil and lamivudine. Daily excretion of urinary protein, serum albumin, liver function（ALT, AST）, renal function, hepatitis B markers（HBeAg, HBV- DNA） and the side effects were all observed. Results：Eleven out of 13 cases finished the study, The total effective rate was 81. 896 after one year＇ s treatment, while 4 of 11 cases achieved complete remission（36.4 % ） and 5 cases partial remission（45, 5 % ）, Daily urinary protein excretion was significantly reduced by the combined treatment with mycophenolate mofetil and lamivudine （P〈0.01）. The serum albumin was significantly increased（P〈0.01）. There were no serious adverse effects during the period of administrating the drugs. Conclusion： This preliminary study demonstrated that the combined therapy with mycophonolate mofetil and lamivudine is effective and safe for patients with HBV- GIN.

关 键 词：吗替麦考酚酯 联合用药 拉米夫定 药物治疗 乙型肝炎病毒相关性肾炎 

分 类 号：R692.3[医药卫生—泌尿科学] R512.62[医药卫生—外科学]