吗替麦考酚酯治疗难治性肾病综合征的疗效分析  

Mycophenolate Mofetil in the Treatment of Refractory Nephrotic Syndrome

作　　者：白鸽[1] 白云凯[1] 

机构地区：[1]昆明医科大学第一附属医院肾脏内科,云南昆明650032

出　　处：《现代诊断与治疗》2017年第17期3139-3141,共3页Modern Diagnosis and Treatment

摘　　要：目的观察吗替麦考酚酯联合糖皮质激素治疗难治性肾病综合征疗效及安全性。方法回顾性分析我院2015年1月~2016年12月原发性肾病综合征患者32例,吗替麦考酚酯起始剂量1.0~1.5g/d,定期监测血药浓度,据血药浓度及临床指标等减量,观察治疗前、治疗后6个月血清白蛋白、24小时尿蛋白定量、血肌酐、胆固醇及用药过程中不良反应。结果治疗过程中32例患者均未出现严重不良反应,治疗前后血清白蛋白、24小时尿蛋白、血清肌酐、胆固醇差异有显著统计学意义。规范治疗6个月后,32例患者中,完全缓解9例,部分缓解16例,无效7例。结论吗替麦考酚酯联合糖皮质激素在治疗难治性肾病综合征过程中大部分患者可以达到完全缓解或部分缓解,在用药过程中定期检测血药浓度,未发生严重不良反应,安全性较好。Objective To observe the efficacy and safety of mycophenolate mofetil combined with glucocorticoid in the treatment of refractory nephrotic syndrome.Methods A retrospective analysis of our hospital from January 2015 to December 2016,32 cases of primary nephrotic syndrome,mycophenolate mofetil starting dose of 1.0 -1.5 g/day, regular monitoring of blood drug concentration, according to the serum concentration and clinical index reduction, before treatment, 6 months after treatment,serum albumin,24 hours urinary protein, serum creatinine, cholesterol and process of drug adverse reaction.Results In the course of treatment, 32 patients had no serious adverse reactions.Serum albumin,24 hours urine protein, serum creatinine and cholesterol had significant difference before and after treatment. After standard treatment for 6 months,32 patients had complete remission in 9 cases,partial remission in 16 cases, and ineffective in 7 cases.Conclusion Mycophenolate mofetil combined with glucocorticoid in the treatment of refractory nephrotic syndrome in most patients can achieve complete remission or partial remission,regular examination of blood drug concentration in the process of treatment, no serious adverse reactions,good safety.

关 键 词：难治性肾病综合征 吗替麦考酚酯 糖皮质激素 

分 类 号：R692[医药卫生—泌尿科学]