霉酚酸酯联合环磷酰胺与单纯霉酚酸酯治疗IV型狼疮性肾炎的疗效比较

目的：回顾性研究中小剂量霉酸酸酯（MMF）联合环磷酰胺（CTX）间断冲击与单纯霉酚酸酯治疗狼疮性肾炎IV型两者的疗效差异．方法：对2006年6月至2009年12月在我院住院进行肾活检确诊为狼疮性肾炎IV型患者进行一般情况、临床表现、病理特征、治疗缓解率、复发率、副作用发生率及预后的治疗观察并进行对比分析。结果：50例LN（IV）忠者中，接受联合治疗的患者为26例，单纯使用MMF患者24例，两组病例在一般情况，临床表现、病理损害程度无显著性差异，两组治疗12个月时缓解率分别为79．1％和75．1％，联合治疗组完全缓解率为58．3％，显著高于MMF组31．8％，复发率12．5％较单纯使用MMF组减少，两者复发的发生原因大多来源于部分缓解者，比较两者在副作用方面，联合治疗组与单纯治疗组副作用对比未发现明显增加，联合治疗组有2例出现轻度肝功能损害，白细胞下降1例，单纯治疗组有l例出现了肝功能损害，1例白细胞下降，进行统计学处理，无显著性意义。结论：两者比较，联合治疗组治疗效果更明显，复发率下降，但未发现有更大的毒副作用。

objective： To Compare the difference of curative effect between low--dose mycophenolate mofetil （MMF） joint cyclophosphamide （CTX） and continuous pure myeophenolate mofetil （MMF） in the induction therapy of lupus nephritis IV. Methods： All the patients who were hospitalized in our hospital renal biopsy were diagnosed patients with lupus nephritis IV between June 2006 and December 2009. General conditions, clinicopathologieal find- ings, remission rate , relapse rate ,prognosis of side effects, and treatment were analyzed. Results： No significant differences was found between to accept combination therapy for patients with 26 cases and only to MMF 24 cases were groups of cases in general condition and pathological findings, two groups of 12 months respectively for 79.1% 75.1%, combined treatment group and complete remission rate for 58.3%, significantly higher 31.8% group, 12. 5% MMF is pure, using MMF group reduce relapse occurred from the cause of most, To compare drug side--effects, combined treatment group compared with simple treatment group effects that increased significantly, combined treatment group in 2 cases of liver damage, leucocyte decline in 1 cases, simple treatment group 1 cases appeared, liver, 1 drop leucocyte, no statistical significance. Conclusion： combined treatment group between therapeutic effect in- creased, and the recurrence rate to drop, but not to found a greater toxicity.