吗替麦考酚酯治疗以蛋白尿为主的儿童紫癜性肾炎疗效观察被引量：23

Therapeutic effect of mycophenolate mofetil on Henoch-Schnlein purpura nephritis children with nephrotic-range proteinuria

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摘要目的评价吗替麦考酚酯(MMF)分散片联合小剂量激素治疗以蛋白尿为主的儿童难治性紫癜性肾炎的临床疗效及安全性。方法选取19例以蛋白尿为主的难治性紫癜性肾炎儿童作为研究对象,其中5例在MMF治疗之前接受肾活检(轻度系膜增殖性肾炎2例,中度系膜增殖性肾炎伴新月体形成1例,重度系膜增殖性肾炎1例,局灶节段性肾小球硬化1例)。泼尼松0.5～1.0 mg/(kg.d),平均0.74 mg/(kg.d),尿蛋白转阴2周后逐渐减量,半月减5～10 mg至5～10 mg/d维持;MMF分散片20～25 mg/(kg.d),2次/d。随访1～1.7年。治疗期间定期复查血常规、尿常规、肾功能、肝功能以及24 h尿蛋白定量等,治疗3个月后进行疗效及安全性评价。结果 MMF分散片联合小剂量激素治疗前、后24 h尿蛋白定量和血清白蛋白差异有统计学意义(P<0.01)。治疗3个月后19例中完全有效17例,部分有效2例。1例应用MMF后2个月合并水痘,1例出现了胃肠道症状,2例一过性白细胞减少。结论吗替麦考酚酯分散片联合小剂量泼尼松能有效缓解以蛋白尿为主的儿童紫癜性肾炎尿蛋白,改善病情,且近期不良反应少,安全性高,依从性好。

作者赵德安毕凌云杨达胜韩子明

机构地区新乡医学院第一附属医院儿内科

出处《临床儿科杂志》 CAS CSCD 北大核心 2011年第4期328-330,共3页 Journal of Clinical Pediatrics

关键词吗替麦考酚酯过敏性紫癜肾炎蛋白尿儿童 mycophenolate mofetil Henoch-Schnlein purpura nephritis proteinuria children

分类号 R726.9 [医药卫生—儿科]

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参考文献10

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