霉酚酸酯联合强的松治疗乙肝病毒相关性肾炎

Study on Mycophenolate Mofetil Combined with Prednisone in Treating HBV-GN

目的 :对比霉酚酸酯 (MMF)联合强的松与硫唑嘌呤联合强的松治疗乙肝病毒相关性肾炎 (HBV_GN)的疗效。方法 :A组服用MMF ,B组服用硫唑嘌呤。2组均服强的松。观察2组治疗有效率、乙型肝炎病毒复制指标、肝肾功能及治疗中的不良反应。结果 :2组肾组织中以HBsAg沉积为主 ;肾组织中乙肝病毒抗原成分与外周血不成比例 ;A组治疗后 ,尿蛋白排泄率显著降低 ,血清白蛋白水平明显升高(均P<0.05) ,而B组治疗前后两指标无显著性差异 ;治疗期间A组中有2例复发 ,重新治疗后均有效。结论 :MMF结合激素治疗HBV_GN有较明显的疗效 。

To compare the effects of treatment methods between Mycophenolate mofetil(MMF)and azathioprine(AZT)combined with prednisone respectively in treating HBV_GN.Methods:MMF was administered in group A,and AZT in group B.Prednisone was administered in both groups.The treatment effect rate,albuminuria amount,reproducing target of HVB(HbeAg,HBV_DNA),renal and liver function,and side effect were observed.Results:The main deposition in renal tissue was HBsAg.The depositions were out of proportion with component of HBV antigen in blood.After using MMF,the 24 hours albuminuria amount decreased significantly (P<0.05),and ALB increased significantly(P<0.05).Conclusion:MMF combined with prednisone to treat HBV_GN has an obvious effect compared with AZT combined with prednisone.MMF was safe and had fewer side effects in present dose with easily recurrence.