摘要
目的:比较霉酚酸酯(MMF)与环磷酰胺(CTX)静脉冲击疗法治疗Ⅳ型狼疮性肾炎(LN)的近期疗效及对肾脏病理改变的影响。方法:28例患者均经临床和肾活检确诊为Ⅳ型LN,随机分为2组,MMF治疗组用糖皮质激素联合MMF(1.0～1.5g·d-1)治疗;CTX组用糖皮质激素联合CTX治疗。结果:治疗12个月时MMF组蛋白尿及血尿下降程度大于CTX组。尿蛋白下降和尿红细胞减少超过基础值50%者,MMF组分别为78.6%和92.9%,CTX组分别为42.9%和57.1%。MMF组降低ANA及ds-DNA抗体的作用优于CTX组。治疗4～7个月时重复肾活检显示,MMF治疗组肾组织学活动性指数(AI)下降程度大于CTX组,MMF治疗组AI由16.9±6.4降至3.5±1.6,CTX组AI由15.2±3.8降至6.4±1.2。MMF组感染并发症发生率低于CTX组。结论:激素联合MMF控制Ⅳ型LN的疗效优于CTX且副反应低。
Objective:To compare clinical efficacy and the influe nc es on renal histological lesions between My cophenolate mofetil(MMF)and cyclop hosphamide(CTX)therapy in diffuse proliferative lupus nephritis(DPLN).Metho ds:Twenty-eight patients with active DPLN were randomly divided into two gro ups:MMF group:14cases were treated by MMF at a dosage of1.0～1.5g·d-1 .CTX group:Another14cases were given pulse therapy with CTX (0.75～ 1.0g·m-2 BSA).Both of groups were given intravenous methylprednisolone and then ora l prednisone.All patients were treated for more than12months.Patients in two groups were comparable in age,sex distribution and severity of renal damage. Result:MMF therapy was found to be more effective in reducing proteinuria and hematuria,with the decrement below the half of baseline urinary protein excret ion and urinary red blood cell count in78.6%and92.9%cases in MMF gro up,while only42.9%and57.1%in CTX group respectively.The repeated ren al biopsy demonstrated that reduction of active index was more prominent in MMF group.The incidence of gastrointestinal symptoms and infectious compli catio ns were lower in MMF group.Conclusion:MMF was more effective in controlling of DPLN than CTX pulse therapy with fewer complicarions.
出处
《山东大学学报（医学版）》
CAS
2003年第6期692-694,共3页
Journal of Shandong University:Health Sciences
关键词
狼疮肾炎
霉酚酸
环磷酰胺
Lupus nephri tis
Mycophenolic acid
Cyclophosphamide
