早期、足量应用激素联合吗替麦考酚酯对增殖性狼疮性肾炎患者疗效及预后的影响

Effects of early and adequate use of hormone combined with mortethaphenolate on the efficacy and prognosis of patients with proliferative lupus nephritis

目的分析早期、足量应用激素联合吗替麦考酚酯对增殖性狼疮性肾炎患者的疗效及预后的影响。方法选取重庆市开州区人民医院内科2016年4月～2017年10月收治的92例增殖性狼疮性肾炎患者,按随机数字表法将其分为两组,每组各46例。对照组早期应用足量激素和环磷酸酰胺治疗,观察组早期应用足量激素联合吗替麦考酚酯治疗,比较两组临床疗效。结果与对照组比较,观察组治疗总有效率明显升高(P <0.05),治疗后的尿素氮、血肌酐水平及24 h尿蛋白定量结果与对照组比较,差异有统计学意义(P <0.05)。观察组不良反应总发生率明显低于对照组(P <0.05)。经1年随访,观察组患者的肾脏病复发率明显低于对照组(P <0.05)。结论早期、足量应用激素联合吗替麦考酚酯对增殖性狼疮性肾炎有显著疗效,可改善患者肾功能,降低肾脏病复发风险,且药物安全性较高。

Objective To analyze the effect of early and sufficient application of hormone combined with mortethaphenolate on the efficacy and prognosis of patients with proliferative lupus nephritis.Methods From April 2016 to October2017,92 patients with proliferative lupus nephritis admitted and treated in the Department of Internal Medicine of the People′s Hospital of Kaizhou District Chongqing were selected and divided into two groups according to the random number table method,46 patients in each group.The control group was treated with adequate Hormone and Cyclophosphamide at the early stage,and the observation group was treated with adequate Hormone combined with Motimecophenolate at the early stage,and the clinical effects of the two groups were compared.Results Compared with the control group,the total effective rate was significantly increased in the observation group(P<0.05),and the results of urea nitrogen,serum creatinine level and 24 h urine protein quantification after treatment were lower than the control group,with statistically significant differences(P<0.05).The total incidence of adverse reactions in the observation group was significantly lower than that in the control group(P<0.05).After 1 year follow-up,the recurrence rate of renal disease in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Early and sufficient application of Hormone combined with Morteofloxacin has a significant effect on proliferative lupus nephritis,which can improve the renal function of patients,reduce the risk of renal recurrence,and the drug safety is relatively high.