霉酚酸酯联合中小剂量糖皮质激素隔日疗法治疗儿童过敏性紫癜肾炎的疗效  

The effectiveness of mycophemolatemofeil therapy with medium prednisone treatment in patients with Henoch-Schonlein purpura nephritis

作　　者：徐达良[1] 董扬[1] 茅爱芳 江家云[1] 周慧琴[1] 张媛媛[1] 

机构地区：[1]安徽省立儿童医院肾内科,合肥230051

出　　处：《安徽医学》2010年第2期101-103,共3页Anhui Medical Journal

基　　金：安徽省自然科学基金(NO:070413254X)

摘　　要：目的观察霉酚酸酯(MMF)联合中小剂量糖皮质激素隔日治疗儿童过敏性紫癜肾炎(HSPN)的疗效,以探讨儿童HSPN的最佳治疗方案。方法回顾性分析2006年5月至2008年5月在安徽省立儿童医院住院的HSPN患儿25例,男性16例,女性9例,处于病情的急性期,给予MMF联合中小剂量糖皮质激素隔日治疗。MMF初始剂量为20 mg/(kg.d)(总量<1.5 g/d),疗程3～9个月,泼尼松初始剂量1.0 mg/(kg.d)(总量≤60 mg/d)隔日晨起顿服。结果①25例患儿MMF治疗过程中未见明显副反应;②肾活检示HSPNⅡb级者8例,在加用MMF治疗的3～6个月获得缓解。HSPNⅢ级者7例在治疗的4～6个月获得缓解,而另6例表现为中等量以上的蛋白尿Ⅲ级者及3例Ⅳ级者,先应用甲基强的松龙冲击治疗20 mg/(kg.d)(总量≤1.0 g/d),3天为一疗程,共用1～2疗程,其后再给予MMF联合中小剂量泼尼松隔日治疗3～6个月获得缓解。1例FSGS患儿应用经过至少6个月的足量MMF治疗无效。在治疗过程中有5例患儿在减量或停药后出现疾病的复发或部分复发,重新应用MMF治疗后获得缓解。结论MMF联合中小剂量的泼尼松能有效地治疗儿童HSPN,较长时间应用无明显副反应。Objective To study the effectiveness of mycophemolatemofeil（MMF） therapy with medium prednisone treatment in patients with Henoch-Schonlein purpura nephritis.Methods 25 patients treated as objectives were addmited in Anhui provincial children＇s hospital during May 2006 to May 2008.The patients were treated with MMF with 20 mg/（kg·d）,at the same time prednisone 1 mg/（kg·d）.The period of treatment lasted 3~9 months.Results ①25 patients were treated with MMF,during this period,there were no significant side effects in all patients.②8 patients of Ⅱb acquired complete remission after 3-months treated with MMF;7 patients of Ⅲ acquired complete remission after 4~6-months treatment with MMF.6 patients of Ⅲand 3 patients of Ⅳ acquired complete remission or partial remission after 4~6-months treatment with MMF,before doing this,they were treated with methylprednisolone pulse therapy at a dosage of 20mg/（kg.d）（total dosage≤1.0 g/d）.Conclusion MMF combined with medium prednisone treatment in patients with Henoch-Schonlein purpura nephritis is more efficacy and less side-effect.

关 键 词：霉酚酸酯 过敏性紫癜肾炎 治疗 儿童 

分 类 号：R726.9[医药卫生—儿科]