霉酚酸酯联合激素治疗以肾病综合征为主要表现的Ⅳ型狼疮性肾炎疗效观察

Clinical research of mycophenolate morfetil combined prednisone in treatment of class Ⅳ 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主要表现的Ⅳ型狼疮性肾炎(LN)的临床疗效。方法:将已经肾活检确诊为肾病综合征的Ⅳ型LN的患者随机分为MMF治疗组(35例)及环磷酰胺(CTX)治疗组(30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,各种自身抗体减少,MMF组相对于CTX组对外周血象及肝功的影响不明显。结论:MMF治疗以肾病综合征为主要表现的LN是安全有效的。

Objective：To investigate the clinical therapeutic efficacy of mycophenolate morfetil （MMF） combined prednisone in the treatment of class IV nephritis （LN） with nephrotie syndrome （NS）. Methods： 65 patients of classIV LN with NS were randomly devided into two groups. Group A （35 patients） were treated with MMF and group B （30 patients） were treated with cyclophosphamide（CTX）. Both groups were treated with standard-dose prednisone. Results：After the treatment, the laboratory index, including urine protein, urine red blood cell,creatinine,C3, C4,ANA and serum levels of ds-DNA antibody,were improved. The blood cell and hepatic function of group B were impacted, whereas those of group A were not. Conclusion：The therapy of MMF plus prednisonc is a safe and effective method for class IV LN with NS.