霉酚酸酯治疗MPO-ANCA阳性狼疮性肾炎15例

Mycophenolate Mofetil in the Treatmeat of 15 Cases of MPO-ANCA Positive Lupus Nephritis

目的 :探讨霉酚酸酯 (MMF)对抗髓过氧化物酶抗体 (MPO ANCA)阳性狼疮性肾炎 (LN)的治疗效果及不良反应。方法 :15例MPO ANCA阳性LN患者给予MMF及糖皮质激素治疗 ,MMF起始量 1.5～ 2 .0g·d 1 ,病情缓解后MMF逐渐减量至 0 .5～ 0 .75g·d 1 维持 ,平均随访 (14 .5 6± 5 .10 )个月。结果 :完全缓解 10例 ,部分缓解 3例 ,无效 2例 ,其中 3个月内缓解 7例。治疗过程中未发现明显的副作用。结论 :MPO ANCA阳性LN为一特殊的临床和病理类型 ,MMF能有效地控制其临床活动 ,早期缓解率高 ,副作用少而轻。

Objective:To study the effect and side effects of mycophenolate mofetil (MMF) in treating patients with myloperxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA) positive patients with LN all were treated with MMF in combination with cirticosteroid. The starting dose og MMF ranged from 1.5 g·d -1 to 2.0 g·d -1 , and follow-up study lasted for (14.56±5.10) months。 Method:Clinical efficacy was defined as remission, partial remission and no responds. The dose of MMF was gradurally reduced to maintenance dose of 0.5-0.75 g·d -1 after the patients achieved remission or partial remission. Results:Rensl remission occurred in 10 of 15 patients, 3 patients achieved partial remission, 2 patients achieved remission in 3 months. No obvious side effects were observed during MMF treatment. Conclusion:MPO-ANCA positive LN is a special type in pathology. The rates of hematuria and injury of renal function were higher than those of the ordinary type. MMF is effective for active glomerular lesion of refractory severs LN and has a higher remission rate in earlier period but less side effects.