霉酚酸酯治疗原发小血管炎的疗效观察

Efficacy of mycophenolate mofetil treatment for primary small vessel vasculitis

目的观察霉酚酸酯和间断环磷酰胺静脉冲击治疗原发小血管炎的疗效、不良反应和复发率。方法我院2010年1月至2011年1月收治的25例原发小血管炎患者随机分为霉酚酸酯组(MMF组)12例,间断环磷酰胺静脉冲击组(CTX组)13例。比较两组病情缓解率、不良反应发生情况、患者肾功能变化、复发情况等。结果 MMF组患者缓解率、肾功能恢复率、ANCA变化转阴率均明显优于CTX组(P<0.05);MMF组不良反应发生率低于CTX组(25.0%vs.38.6%,P<0.05)。结论与传统间断环磷酰胺静脉冲击治疗相比,采用霉酚酸酯治疗原发小血管炎,缓解率更高,复发率更低,且肾功能恢复情况较为理想。

Objective To investigate the efficacy,adverse effects and the recurrent rate of mycophenolate mofetil and cyclophosphamide treatment for primary small vessel vasculitis.Methods 25 cases with primary small vessel vasculitis in our hospital from January 2010 to January 2011 were randomly divided into mycophenolate mofetil group（MMF group,n=12） and cyclophosphamide group（CTX group,n=13）.The remission rate,side effects,change of renal function and the recurrence of the patients were compared.Results The remission rate,recovery rate of renal function,changes in ANCA negative rate in MMF group were obviously better than those of CTX group（P0.05）; the incidence of adverse reaction of MMF group was lower than that of CTX group（25.0% vs.38.6%,P0.05）.Conclusion Compared with traditional cyclophosphamide treatment,mycophenolate mofetil has higher remission rate,lower recurrence rate,and the recovery of renal function is better in treating primary small vasculitis.