霉酚酸酯对狼疮性肾炎患者颈动脉内膜-中膜厚度的影响

Effect of mycophenolate mofetil (MMF) on carotid intima-media thickness (IMT) of patients with lupus nephritis

目的探讨霉酚酸酯(MMF)对狼疮性肾炎(LN)患者的动脉粥样硬化指数(AI)及颈动脉内膜-中膜厚度(IMT)的影响。方法 45例LN患者用MMF治疗(MMF组,23例)和环磷酰胺(CTX)治疗(CTX组,22例),比较治疗前后AI、IMT和系统性红斑狼疮疾病活动性指数(SLE-DAI)的变化。结果两组治疗前后的IMT、AI和SLE-DAI比较差异均无统计学意义(P>0.05)。MMF组和CTX组治疗缓解率分别为81.8%和69.6%(P>0.05)。缓解病例治疗前后IMT变化值明显小于未缓解病例(P<0.05)。结论 MMF治疗LN的1年疗效与CTX相仿;LN病情控制者的IMT增厚明显减慢。

Objective To observe the changes of carotid intima-media thickness （IMT） and arteriosclerosis index （AI） in the patients with lupus nephritis （LN） after treatment with mycophenolate mofetil （MMF）. Methods Forty-five patients with biopsy-proven LN were treated with MMF（group MMF, 23 cases） and with conventional intermittent cyclophosphamide （CTX） therapy （group CTX, 22 cases）. Supplemental steroid treatment was offered in the same manner to both groups. Therapeutic effects were evaluated at the end of one-year treatment. Results Compared to before, the changes of IMT, AI and systemic lupus erytbematosus-diseases activity index（SLE-DAI） were not significant after treatment（P〉0. 05）. The remission rates of groups of MMF and CTX were 81.8% and 69. 6%, respectively（P〉0. 05）. The change of IMT before and after treatment was less in LN cases with remission disease than that in those without（P〈0. 05）. Conclusion The efficacy of MMF therapy for 1 year is similar to that of CTX in the patients with LN. The increase of IMT slows down when LN is improved effectively by treatment.