霉酚酸酯联合强的松治疗以肾病综合征为表现的难治性狼疮性肾炎38例临床观察

Clinical research of mycophenolate morfetil combined prednisone in treatment of refractory lupus nephritis with nephrotic syndrome

目的探讨霉酚酸酯(MMF)联合强的松治疗以肾病综合征为表现的难治性狼疮性肾炎(LN)的临床疗效。方法将已确诊为肾病综合征的LN患者随机分为MMF治疗组38例及环磷酰胺(CTX)治疗组40例,并分别以MMF及CTX进行相应治疗,两组均联合标准剂量的强的松。结果治疗后两组的尿蛋白、尿红细胞、肾功能及低补体血症均得到显著改善,各种自身抗体迅速减少,MMF组对外周血象及肝功的影响不明显,而CTX组则表现为血常规WBC、RBC及PLT水平下降,肝功能表现为ALT、GGT升高。结论MMF治疗以肾病综合征为表现的LN是安全有效的。

Objective To investigate the clinical therapeutic efficacy of mycophenolate morfetil （MMF） combined prednisone in the treatment of refractory lupus nephritis （LN） with nephrotic syndrome （NS）. Methods Seventy-eight patients of LN with NS were randomly devided into two groups., group A including thirty-eight patients treated with MMF and group B including forty patients treated with cyclophosphamide （CTX）. Two groups were both treated with standard prednisone. Results After the treatment, the laboratory indices changed of, including urine protein, urine red blood cell, creatinine, C3, C4, ANA and serum levels of anti-double strain DNA antibody. The group treated with CTX showed evident effect on blood routine and hepatic function, while the group treated with MMF did not. Conclusion The therapy with MMF plus prednisone is a safe and effective method for refractory LN with NS.