摘要
目的:比较霉酚酸脂(MMF)与环磷酰胺(CTX)静滴治疗重症IgA肾病的临床疗效。方法:41例重症IgA肾病患者分别采用激素联合MMF治疗(MMF组,n=21),或采用激素联合CTX静注治疗(CTX组n=20)。MMF剂量为1.5g/d,诱导疗程均≥6个月;CTX剂量为0.4 g,隔日1次静脉滴注,总量≤8 g。两组患者基础病情无差异,随访时间≥12个月,疗效指标包括临床缓解率2、4 h尿蛋白定量和血脂变化。观察两组的临床疗效和副作用。结果:①临床缓解率:治疗12个月时,MMF组临床总有效率高于CTX组,分别为90.4%和60.0%(P<0.05);②MMF组24 h尿蛋白明显低于CTX组(0.6±0.3和1.4±0.8,P<0.05);③MMF组血脂明显降低(P<0.05),而CTX组无变化;④MMF组副作用的发生率明显低于CTX组(9.5%和40%,P<0.05)。结论:激素联合MMF治疗重症IgA肾病,临床缓解率高于CTX静脉滴注疗法,能更有效降低蛋白尿,改善血脂水平,且副作用发生率低于CTX疗法。
Objective： To compare the clinical efficacy of mycophenolate rnofetil （MMF） with that of cyclopbosphamide（CTX） in the treatment of severn IgA nephropathy. Methods：Forty - one patients with severe IgA nephropathy were enrolled into this study and were divided into MMF and CTX groups. MMF group included 21 cases that were treated with MMF at a dosage of 1.5 g/d. CTX group enrolled 20 cases that were given intravenous drip 0. 4 g/2d and the total dosage was less than 8 g. The patients were followed up for more than 12 months. The clinical efficacy and side effects wexe compared between the two groups. Results： （1） Clinical remission rate in the 12th month was 90. 4% in MMF therapy and it was 60. 0% in CTX group. The difference of the clinical remission rate between the two groups was significant （P〈0. 05）. （2） The concentration of proteinuria in 24 h in MMF group was lower than that in CTX group（P〈0. 05）. （3） After the therapy, the level of blood - lipid decreased obviously in MMF group, but it did not changed in CTX group （P〈0. 05）. （4） The side effect in both groups were 9. 5%（ MMF group） vs 40% （ CTX group） （P〈0. 05）. Condusion： The combination therapy of MMF and steroid was more effective than CTX intravenous drip in treatment of severe IgA nephropathy and has fewer side effects.
出处
《西南国防医药》
CAS
2007年第3期289-291,共3页
Medical Journal of National Defending Forces in Southwest China
关键词
IGA肾病
霉酚酸脂
环磷酰胺
治疗
IgA nephropathy
mycophenolate mofetil
cyclophosphamide
treatment
