吗替麦考酚酯联合糖皮质激素治疗特发性膜性肾病的临床疗效以及安全性

目的 观察吗替麦考酚酯联合糖皮质激素治疗特发性膜性肾病（IMN）的疗效以及安全性,并和环磷酰胺联合激素治疗组对比.方法 入组40例肾病综合征的患者,经肾穿活检证实为特发性膜性肾病,分为两组,治疗组为吗替麦考酚酯（MMF）联合激素,对照组为环磷酰胺（CTX）联合激素治疗.分别于治疗前,治疗后第1个月、第3个月、第6个月测量血肌酐、24小时尿蛋白、血白蛋白、血低密度脂蛋白、胆固醇,计算缓解率以及副作用的发生.结果 两组患者24小时尿蛋白在治疗后第1个月、第3个月、第6个月均有下降,第6个月与治疗前相比差异有统计学意义（P＜0.05）,血清白蛋白在治疗后第1个月、第3个月、第6个月均有上升,第6个月与治疗前相比差异有统计学意义（P＜0.05）.缓解率方面,MMF组为55％,CTX组为60％,差异无统计学意义（P＞0.05）.结论 MMF联合激素治疗膜性肾病与环磷酰胺的疗效相似

Clinical trial on the efficacy and safety of mycophenolate mofetil and prednisone in the treatment of idiopathic membranous nephropathy

Objective To investigate efficacy and safety of mycophenolate mofetil （MMF） plus prednisone in the treatment of idiopathic membranous nephropathy （IMN）. Methods 40 patients who were diagnosed as nephritic syndrome and whose renal biopsy were showed idiopathic membranous nephropathy, were enrolled into our trim and divided into two different groups. One group was MMF combined prednisone, and the other group was Cyclophosphamide （CTX） combined predni- sone. Clinical data were recorded in the Ist, 3rd, and 6th month, including serum creatinine （ Scr）, urine protein of 24- hours, serum albumin （ALB）, low density lipoprotein cholesterol （ LDL）, remission rate, and side effects. Results In the MMF group, urine protein of 24-hours, decreased significantly （P 〈 0. 05）, while ALB increased significantly （P 〈 0. 05）. The same was CTX group. Remission rate were similar （P 〉 0. 05）. Conclusion Efficacy and safety of mycophenolate mofetil （MMF） plus prednisone in the treatment of idiopathic membranous nephropathy （IMN） is similar with CTX plus prednisone.