吗替麦考酚酯联合小剂量醋酸泼尼松治疗膜性肾病的疗效观察

Observation on Efficacy of Mycophenolate Mofetil Combined with Low-Dose Prednisone Acetate in Treatment of Membranous Nephropathy

目的:探讨吗替麦考酚酯联合小剂量醋酸泼尼松治疗膜性肾病的临床疗效。方法:选取2016年1月至2016年10月襄阳市第一人民医院收治的原发性膜性肾病患者86例,以随机数字表法分为观察组和对照组,每组43例。观察组患者给予吗替麦考酚酯联合小剂量醋酸泼尼松治疗,对照组患者给予足量醋酸泼尼松治疗。比较两组患者治疗12、24周后的临床疗效,24 h尿蛋白定量,血清白蛋白、空腹血糖、血清肌酐(SCr)、血尿素氮(BUN)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)水平及不良反应发生情况的差异。结果:治疗12、24周后,观察组患者的总有效率明显高于对照组,差异均有统计学意义(P<0.05)。治疗12、24周后,观察组患者24 h尿蛋白定量明显低于对照组,血清白蛋白水平明显高于对照组,差异均有统计学意义(P<0.05);两组患者空腹血糖、SCr、BUN、AST及ALT水平的差异均无统计学意义(P>0.05)。治疗期间,观察组患者的不良反应发生率为20.9%(9/43),明显低于对照组的44.2%(19/43),差异有统计学意义(P<0.05)。结论:吗替麦考酚酯联合小剂量醋酸泼尼松治疗膜性肾病的疗效较好,且不良反应少。

OBJECTIVE:To probe into the clinical efficacy of mycophenolate mofetil combined with low-dose prednisone acetate in treatment of membranous nephropathy.METHODS:86 patients with primary membranous nephropathy admitted into the First People'Hospital of Xiangyang from Jan.2016 to Oct.2016 were selected and divided into observation group and control group via random number table,with 43 cases in each group.The observation group was given mycophenolate mofetil combined with low-dose prednisone acetate,while the control group was treated with full-dose prednisone acetate.Differences in clinical efficacy,24 h urine protein quantitation,serum albumin,fasting blood-glucose,serum creatinine(SCr),blood urea nitrogen(BUN),aspartate aminotransferase(AST),alanine aminotransferase(ALT)and incidences of adverse drug reactions at 12 weeks and 24 weeks after treatment between two groups were compared.RESULTS:At 12 weeks and 24 weeks after treatment,the total effective rate of observation group was significantly higher than that of the control group,with statistically significant difference(P<0.05).At 12 weeks and 24 weeks after treatment,the 24 h urine protein quantitation of observation group was significantly lower than that of the control group,while the serum albumin of observation group was significantly higher,with statistically significant differences(P<0.05);there were no statistical significance in differences in fasting blood-glucose,SCr,BUN,AST and ALT levels between two groups(P>0.05).During treatment,the incidence of adverse drug reactions of observation groupwas 20.9%(9/43),which was significantly lower than that of the control group(44.2%,19/43),with statistically significant differences(P<0.05).CONCLUSIONS:The efficacy of mycophenolate mofetil combined with low-dose prednisone acetate in treatment of membranous nephropathy is remarkable,with few adverse drug reactions.