吗替麦考酚酯、缬沙坦与来氟米特治疗原发性肾病综合征的疗效比较

Compared the efficacy of Mycophenolate mofetil, valsartan and leflunomide in the treatment of primary nephrotie syndrome

目的：了解吗替麦考酚酯（MFF）、缬沙坦联合小剂量激素，以及来氟米特联合小剂量激素治疗原发性肾病综合征的疗效。方法：经肾穿刺活检并结合临床确诊为原发性肾病综合征38例，随机分成两组，实验组20例，服用吗替麦考酚酯、缬沙坦及强的松；对照组18例，服用来氟米特及强的松。结果：经过24周和48周的治疗，两组患者尿蛋白均显著下降（P〈0．01），血浆白蛋白均显著回升（P〈0．05），血总胆固醇均显著下降（P〈0．05）。治疗48周时，MMF联合缬沙坦实验组完全缓解率．总有效率分别为45％、90％，对照组分别为38．9％、77，8％。MEF及缬沙坦实验组的完全缓解率、总有效率与对照组相比其差异有统计学意义（P〈0．05）。结论：MFF联合缬沙坦及小剂量激素治疗原发性肾病综合征效果好，不良反应少。

Objective To investigate the effectiveness and safety of Mycophenolate mofetil （MFF）, valsartan combined with small dose of hormones, and leflunomide combined with low-dose hormone treatment of primary nepbrotic syndrome. Method 38 primary nephrotic syndrome patients which were confirmed by renal biopsy, were randomly divided into experimental and control groups. Experimental group included 20 Cases who were treated with mycophenolate mofetil, valsartan and prednisone; Control group enrolled 18 cases who were given leflunomide, and prednisone. Results After treatment of 24 and 48 weeks, two groups of patients with urinary protein were significantly decreased （ P〈0.01）, plasma albumin were significantly recovered （ P〈0.01） ,serum total cholesterol were significantly decreased（ P〈0.01） The complete remission rate and total effective rate at the 48 weeks after MMF combined valsartan and predisone therapy was 45% and90%,and only ,38.9% and 77.8 % respectively in control group. The differences in complete remission and total effective rate between experimental and control group were statistically significant （P 〈0.05）. Conclusions MFF combined valsartan and small doses of hormone is a safe and efective medicine in treatment of primary nephrotic syndrome.