霉酚酸酯治疗儿童激素依赖性肾病综合征的疗效

Efficacy of Mycophenolate Mofetil on Children with Steroid-Dependent Nephrotic Syndrome

目的观察和评价霉酚酸酯（MMF）对儿童激素依赖性肾病综合征（SDNS）的疗效及安全性。方法选取SDNS住院患儿16例。男12例，女4例；发病年龄（5．0±1．6）岁。采用MMF[25mg／（kg·d）]联合小剂量糖皮质激素治疗，0．5年后MMF减半量，维持3个月停药。同时服用泼尼松0．5～1．0mg／（kg·d），平均0．67mg／（kg·d），根据病情定期减量。定期复查尿、血常规、24h尿蛋白定量、血清肌酐和尿素氮、肝功能，治疗3个月后进行疗效及安全性评价。结果治疗3个月后16例中完全有效13例，部分有效3例。MMF联合小剂量激素治疗前后24h尿蛋白定量和血清清蛋白出现显著差异（P〈0．01）。2例分别出现胃肠道症状和一过性白细胞减少。结论MMF是治疗儿童SDNS的一种有效、安全的免疫抑制剂。

Objective To evaluate the clinical efficacy and safety of mycophenolate mofetil（MMF）on children with steroid - dependent nephrotic syndrome（SDNS）, Methods Sixteen children with SDNS, diagnosed at onset, included 12 males and 4 females, aged（5.0 ± 1.6） years, were administrated with MMF[ 25 mg/（kg·d） ] and low - dose prednisone[ 0.5 - 1.0 mg/（ kg·d）, average 0.67 mg/（ kg·d） ]. MMF was reduced to half of initial dosage after 6 months and maintained for 3 months, while dosage of prednisone was tapered gradually based on patients disease profile. Twenty - four hours urinary protein excretion, serum creatinine and blood urea nitrogen, liver function were conducted regularly, respectively, The clinical efficacy and safety were assessed after 3 months treatment. Results Thirteen of 16 patients treated with MMF and prednisone remained in complete remission, Three children remained remission partly. Difference markedly was observed in 24 hours urinary protein excretion and serum albumin before and after treatment, Conclusions MMF is an effective and safe immunosuppressive agent for children with SDNS.