霉酚酸酯联合激素及拉米夫定治疗乙肝相关性肾炎的观察  

Mycophenolate mofetil combined with steroid hormone and lamivudine on the treatment of hepatitis B virus associated glomerulonephritis

作　　者：成彩联[1] 娄探奇[1] 郑振达[1] 石成钢[1] 刘迅[1] 

机构地区：[1]中山大学附属第三医院肾内科,广州510630

出　　处：《中国实用内科杂志》2005年第12期1083-1085,共3页Chinese Journal of Practical Internal Medicine

基　　金：广州市科技局基金资助项目(编号2002Z3-E0183)

摘　　要：目的观察霉酚酸酯(MMF)联合甲泼尼龙、拉米夫定治疗乙型肝炎病毒相关性肾炎的疗效及安全性。方法选出1999-01～2004-01中山大学附属第三医院24例乙型肝炎病毒相关性肾炎达到肾病综合征诊断标准的患者,给予霉酚酸酯1.0～1.5g/d联合甲泼尼龙0.4mg/(kg·d)及拉米夫定0.1g/d治疗6个月,每2周复查尿常规、尿蛋白定量、血常规、血清白蛋白、肝肾功能、HBV-DNA定量。结果治疗后9例完全缓解,11例部分缓解,4例无效。所有患者治疗后未出现明显肝肾功能损害、骨髓抑制等不良反应,未发现病毒复制增加。结论MMF联合甲泼尼龙、拉米夫定治疗乙型肝炎病毒相关性肾炎有效。Objective To investigate the efficacy and safety of mycophenolate mofetil combined with methylprednisolone and lamivudine on the treatment of hepatitis B virus associated glomerulonephritis （ HBV - GN）. Methods Twenty - four patients with hepatitis B virus associated glomerulonephritis were confirmed by renal biopsy and immunohistochemistry, these participant patients were admitted to the Third Affiliated Hospital of Sun Yat- Sen University from Jan, 1999 to Jan, 2004. They were treated by MMF combined with methylprednisolone and lamivudine. The initial dosage of MMF was 1.0 - 1.5 g/d, Methylprednisolone at the dosage of 0. 4mg/ （ kg·d） was used at the beginning of the combined treatment. Lamivudine was in the dosage of 0. 1 g/d. The duration of the treatment was six months. Regular test was conducted every two weeks. Results Nine cases had fully remission, 11 cases had partial remission and 4 cases had no efficiency; no patient deterioration. Renal and hepatic function remained stable, blood cell didn＇t decrease and the reproduction of HBV didn＇t increase during the treatment. Conclusion MMF combined with methylprednisolone and lamivudine is an effective and safe method for HBV -GN.

关 键 词：霉酚酸酯 甲泼尼龙 拉米夫定 乙型肝炎病毒相关性肾炎 

分 类 号：R5[医药卫生—内科学]