霉酚酸酯联合小剂量泼尼松治疗特发性膜性肾病的临床观察  

Clinical Observation of Mycophenolate Mofetil Combined with Low-dose Prednisone on Idiopathic Membranous Nephropathy

作　　者：任迎[1] 胡作祥[2] 罗永辉[1] 单薇[1] 

机构地区：[1]中国医科大学绍兴医院肾内科,浙江绍兴312030 [2]绍兴市人民医院肾内科,浙江绍兴312000

出　　处：《中国现代医生》2011年第26期73-74,96,共3页China Modern Doctor

摘　　要：目的分析霉酚酸酯(MMF)联合小剂量泼尼松联合治疗特发性膜性肾病(IMN)的临床疗效及不良反应。方法选择52例诊断IMN的患者为研究对象,随机分为两组:CTX组,予以CTX 2.5mg/(kg.d);MMF组,予以MMF 1.5g/(kg.d),两组均26例,且予以口服强的松(0.8～1.0)mg/(kg.d),晨起顿服,6～8周后减量5mg,后每4周减5mg至停药,疗程1年。比较两组治疗后的24h尿蛋白定量、血浆白蛋白(Alb)、血肌酐(Scr)和甘油三酯(TG)及不良反应。结果与CTX组相比,MMF组的临床疗效指标:完全缓解率与部分缓解率高;24h尿蛋白定量、Scr和TG水平降低,Alb水平升高;各种不良反应发生率降低(P<0.05)。结论 MMF联合小剂量泼尼松治疗IMN的临床疗效显著,且不良反应较少。Objective To evaluate the efficacy and safety of mycophenolate mofetil （ MMF ） combined with low-dose prednisone as induction therapy for patients with idiopathic membranous nephropathy （ IMN ）. Methods A total of 52 patients with IMN were randomly divided into two groups, CTX group 26 patients, received CTX 2.5 rag/ （ kg · d ） and MMF group 26 patients, received MMF 1.5 g/ （ kg · d ）. Prednisone was gived at the dosage of（ 0.8-1.0 ） mg/ （ kg · d ） in the morning per os in two groups. After 6-8 weeks, the dosage of prednisone were declined at the velocity of 5 mg per 4 weeks until stop it. The course of the treatment was one year. The curative effect indexes of 24 hours urine protein quantitation, plasma albumin （ Alb ）, Ser and TG, and adverse reaction were compared between two groups. Results Compared to CTX group, the complete remission rate and partly remission rate were higher, the levels of 24 hours urine protein quantitation, Scr and TG were lower, Alb level was higher and adverse reaction rate was lower in MMF group （ P 〈 0.05 ）. Conclusion The effect of MMF combined with low-dose prednisone on idiopathic membranous nephropathy was good and adverse reaction rate was low.

关 键 词：霉酚酸酯 泼尼松 特发性膜性肾病 

分 类 号：R692.3[医药卫生—泌尿科学]