摘要
目的探讨霉酚酸酯(MMF)对难治性狼疮肾炎(LN)的疗效。方法观察38例环磷酰胺冲击治疗无效、复发或因毒副反应停药的难治性LN者MMF治疗12个月的疗效及活动指标变化。结果浮肿、关节肿痛、皮疹、血白细胞减低的病例在治疗个月后显著减少,个月后消失。治疗前136个月尿蛋白、血沉、血尿素氮、血肌酐和抗dsDNA抗体显著降低,血白蛋白显著增加;6个月后这些变化趋缓。16例肾功能不全者治疗个月,例(61488%)肾功能恢复正常。在MMF治疗中C3逐步升高、抗核抗体(ANA)逐步下降,变化有统计学意义;C4在治疗12个月后较治疗前有显著升高。毒副反应发生率24%,显著低于治疗前74%。结论MMF对难治性LN有显著疗效且毒副作用小,其疗效变化可能与剂量有关。
Objective To investigate the effects of mycophenolate mofetil (MMF) treatment for refractory lupus nephritis (LN). Methods Thirty eight patients with LN, who had failed intermittent cyclophosphamide (CTX) intravenous treatment or had relapsed or to withdraw because of adverse reactions, had received the MMF treatment for 12 months. The clinical efficacy and immunology indexes were assessed. The dosage of MMF was decreased after treated for 6 months. Results The cases with edema, arthralgia,skin rashes,anemia, low white blood cell and blood urine after one month of MMF treatment were significantly less than that before treatment. Edema, arthralgia, skin rashes and low white blood cell disappeared after 3 months of treatment. During the first 6 month of MMF treatment, urine protein, erythrocyte sedimentation rate, blood urea nitrogen and blood creatinine were significantly reduced, anti-dsDNA antibody titer decreased gradually, serum albumin increased, but the changes became slower after 6 months. The renal function of 14 cases (88%) in 16 patients with renal failure recovered after 6 months of MMF treatment. During MMF treatment serum complement 3 increased and anti-nucleus antidodies decreased, serum complement 4 increased significantly after treatment for 12 months. The difference, compared with that of before treatment, was significant. The incidence of adverse effects of MMF treatment was less than before treatment (24% vs 74%). Conclusion MMF treatment for refractory LN is effective with few side-effects. The efficacy may be dose dependent.
出处
《中华风湿病学杂志》
CAS
CSCD
2005年第2期102-105,共4页
Chinese Journal of Rheumatology
