吗替麦考酚酯联合泼尼松治疗儿童紫癜性肾炎疗效观察

Efficacy of Mycophenolate Mofetil and Prednisone in the Treatment of Children with Henoch-Schnlein Purpura Nephritis

目的:观察吗替麦考酚酯(MMF)和环磷酰胺(CTX)对儿童紫癜性肾炎(肾病综合征型)的疗效及不良反应。方法:选取确诊为紫癜性肾炎的患儿55例,随机分为治疗组31例和对照组24例,治疗组采用泼尼松联合MMF口服治疗,对照组采用泼尼松联合CTX治疗,观察两组临床疗效及不良反应发生情况。结果:两组24 h尿蛋白定量、血清白蛋白均在治疗后2周起有显著改善(P<0.05)。治疗组和对照组尿红细胞计数均有显著下降(P<0.05),下降时间分别为治疗后1个月和3个月。两组总胆固醇及甘油三酯在治疗后6个月起有显著下降(P<0.05)。观察期结束后治疗组和对照组的完全缓解率分别是90.32%和63.64%,两组比较差异有统计学差异(χ2=1.391,P<0.05)。结论:泼尼松联合MMF口服治疗儿童紫癜性肾炎(肾病综合征型)的疗效优于泼尼松联合CTX,且不良反应较少,应用更安全。

Objective： To explore the therapeutic effects and side effects of mycophenolate mofetil （MMF） and eyclophosphamide （CTX） for children with Henoeh-Sch nlein purpura nephritis（HSPN） with nephritic syndrome. Methods： Fifty-five children who were diagnosed as HSPN were randomly divided into two groups. The treatment group was treated with prednisone and MMF oral therapy： The control group was treated with prednisone plus intravenous pulse administration of CTX. The curative effects and side effects between two groups were compared. Results： Twenty-four-hour urinary protein and albumin content in the two groups improved significantly at 2 weeks after treatment. The time of urine red blood cell count decrease significantly in treatment group and control group were 1 and 3months after treatment. Total cholesterol and triglyceride in two groups decreased significantly at 6 months after treatment. After 12 months follow-up, the complete remission rate in treatment group and control group were 90. 32% and 63.64% , they all have statistically significant difference （X2 = 1. 391,P〈0.05 ）. Conclusion： The efficiency of MMF combined with prednisone therapy HSPN with nephritic syndrome in children is better than that of CTX, which has less adverse reactions and application more secure.