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(1)
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[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 1.5 g/(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。
[关键词] 霉酚酸酯；泼尼松；特发性膜性肾病
[中图分类号] R692.3 [文献标识码] B [文章编号] 1673-9701(2011)26-73-02
Clinical Observation of Mycophenolate Mofetil Combined with Low-dose Prednisone on Idiopathic Membranous Nephropathy
REN Ying1 HU Zuoxiang2 LUO Yonghui1 SHAN Wei1
1.Department of Renal Medicine， Shaoxing Hospital， China Medical University， Shaoxing 312030， China； 2.Department of Renal Medicine， People's Hospital of Shaoxing， Shaoxing 312000， China
[Abstract] 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 mg/(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)， Scr 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 ......
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