霉酚酸酯与激素联用对IgA肾病患儿的临床疗效及代谢指标的影响

Influence on clinical effect and metabolic indexes of IgA nephropathy with Mycophenolate Mofetil and hormone

目的研究霉酚酸酯(MMF)与激素联用对IgA肾病(IgAN)患儿的临床疗效及代谢指标的影响。方法选择江苏省徐州市儿童医院2009年7月～2013年7月收治的100例IgAN患儿,随机分为两组。对照组仅给予激素治疗,观察组给予MMF联合激素治疗。对比两组代谢指标变化情况以及疗效、毒副作用情况。结果 1观察组在治疗后尿蛋白定量为(0.66±0.47)g/d,三酰甘油为(1.20±0.53)mmol/L,胆固醇为(5.05±1.26)mmol/L,血肌酐为(80.97±25.77)μmol/L;较治疗前[(2.52±2.06)g/d,(1.94±0.75)mmol/L,(6.83±2.83)mmol/L,(108.72±60.43)μmol/L]以及对照组治疗后[(0.98±0.52)g/d,(1.46±0.61)mmol/L,(5.81±1.34)mmol/L,(92.21±24.87)μmol/L]明显更低。观察组治疗后白蛋白为(41.42±5.92)g/L,较治疗前[(32.69±8.64)g/L]以及对照组治疗后[(38.21±6.72)g/L]明显更高,差异均有统计学意义(均P<0.05)。2观察组总有效率为82.00%(41/50),较对照组的60.00%(30/50)明显更高,差异有统计学意义(P<0.05)。3患者毒副作用轻微,均在可耐受范围。结论 MMF与激素联合治疗IgAN效果显著,能够改善患者代谢,毒副作用轻微,值得临床推荐。

Objective To study the influence on clinical effect and metabolic indexes of IgA Nephropathy （IgAN） with Mycophenolate Mofetil （MMF） and hormone. Methods The total 100 cases of IgAN patients in Children＆#39;s Hospital of Xuzhou City from July 2009 to July 2013 were chosen and randomly divided into two groups. The control group was only treated by hormone; while the observation group was treated by MMF and hormone. The changes of metabolic indexes, efficacy, toxicity were compared between two groups. Results ①The UP [（0.66±0.47） g/d], TG [（1.20±0.53） mmol/L], Cho [（5.05±1.26） mmol/L], Scr [（80.97±25.77） μmol/L] in observation group after treatment were significantly lower than before treatment [（2.52±2.06） g/d, （1.94±0.75） mmol/L, （6.83±2.83） mmol/L, （108.72±60.43） μmol/L] and the control group after treatment [（0.98±0.52） g/d, （1.46±0.61） mmol/L, （5.81±1.34） mmol/L, （92.21±24.87） μmol/L]. The Alb after treatment in observation group [（41.42±5.92） g/L] was higher than before treatment [（32.69±8.64） g/L] and the control group after treatment [（38.21±6.72） g/L], the differences were statistically significant （P〈 0.05）. ②The total effective rate in observation group [82.00% （41/50）] was higher than the control group [60.00% （30/50）], the difference was statistically significant （P〈0.05）.③The adverse reactions were mild, within the tolerable range. Conclusion MMF and hormone desirable a good effect on IgAN, which can improve patients＆#39; metabolism, with slight adverse reaction. It is worthy to be recommended.