小剂量泼尼松联合霉酚酸酯治疗特发性膜性肾病的临床观察  

The Clinical observation of low-dose Prednisone combined with Mycophenolate Mofetil treatment of idiopathic membranous nephropathy

作　　者：龙玉 

机构地区：[1]云南省农垦总局第一职工医院,666101

出　　处：《中国现代药物应用》2011年第21期12-13,共2页Chinese Journal of Modern Drug Application

摘　　要：目的分析小剂量泼尼松联合霉酚酸酯(MMF)治疗特发性膜性肾病(IMN)的临床疗效以及不良反应发生率。方法选择64例诊断IMN的患者为研究对象,随机分为两组:MMF组,予以MMF1.5g/d;CTX组,予以CTX100mg/d,两组均为32例,均予以口服强的松1.0mg/(kg·d),晨起口服,8周后减量5mg,然后每4周减5mg至停药,疗程为1年。比较两组治疗后的血白蛋白(Alb)、血肌酐(Scr)、甘油三酯(TG)和24h尿蛋白定量以及不良反应发生率。结果与CTX组相比,MMF组的完全缓解率与部分缓解率较高,而Alb、TG、Scr和24h尿蛋白定量水平降低,并且各种不良反应发生率明显降低(P<0.05)。结论小剂量泼尼松联合霉酚酸酯治疗IMN的临床疗效可靠,不良反应发生率低。Objective To evaluate the efficacy and safety of low-dose Prednisone combined with Mycophenolate Mofetil（MMF） as induction therapy for patients with idiopathic membranous nephropathy（IMN）. Methods A total of 64 patients with IMN were divided into two groups, randomizedly, MMF group（32 patients, received MMF 1.5 g/d） and CTX group（32 patients, received CTX 100 mg/d）. Prednisone was gived at the dosage of 1.0 mg/（kg·d） in the morning per os in two groups. After 8 weeks,the dosage of prednisone were declined at the velocity of 5 mg/4 weeks until stop it. The course of the treatment was one year.The curative effect indexs of plasma-album（Alb）, Scr, TG and 24 hours urine protein quantitation and adverse reaction occurrence were compared between two groups. Results Compared to CTX group, the complete remission rate and partly remission rate were higher, the level of Alb, TG, Scr and 24 hours urine protein quantitation were lower 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 is good and adverse reaction rate was low.

关 键 词：泼尼松 霉酚酸酯 特发性膜性肾病 临床疗效 

分 类 号：R692.3[医药卫生—泌尿科学]