摘要
目的比较泼尼松联合环磷酰胺和泼尼松联合吗替麦考酚酯对难治性肾病综合征的治疗作用。方法将66例原发性难治性肾病综合征分为两组,分别给予泼尼松+环磷酰胺(对照组)与泼尼松+吗替麦考酚酯(实验组)进行治疗。对比其对患者临床肾病缓解率的影响,并且对比不同联合治疗方法对人体产生的副作用以及其严重程度。其次,对两组临床肾病缓解的患者随访1年,对比两组患者的肾病复发率。结果①泼尼松联合吗替麦考酚酯组治疗患者难治性肾病综合征相对泼尼松联合环磷酰胺更能有效缓解患者病情,提高完全缓解与部分缓解率(P<0.05),并且观察发现实验组整体副作用较少。②对实验组与对照组肾病综合征缓解的患者继续随访1年,结果发现实验组蛋白尿平均值明显低于对照组(P<0.01)。结论在难治性肾病综合征的治疗过程中,泼尼松联合吗替麦考酚酯可以有效使患者病情缓解,并且复发率低,不良反应少,因此这种药物联合方式应逐渐成为难治性肾病综合征治疗的主要方案之一。
Objective To compare the effect of prednisone combining with cyclop- hosphamide and myco- phenolate mofetil in the treatment of refractory nephrotie syndrome （RNS）. Methods Sixty-six patients with RNS were divided into two groups and thirty of them were treated with myeophenolate mofetil based on an routine dosage of prednisone （ experimental group）. The rest of patients were treated with cyclophosp phamide based on an routine dosage of prednisone （ control group） Firstly ： Contrasting the two methods on the remission rate of clinical nephropathy. Secondly： Following up the patients who got remission for one year to find the long term effect on the RNS. Results ① the patients treated with mycophenolate mofetil combing prednisone got higher complete and partial remission rate than the control group （ P 〈 0.05 ） and few of them suffered from hepatic in- sufficiency and the other side effects.② Following up one year of the two group＇ s patients who got complete and partial remission and contrasting the reoccurrance rates of RNS in reference to proteinuria and other bio- chemical indicators. Finally the experimental group had less proteinuria than the control group （ P 〈 0. 01 ） and rare patients in the experimental group got RNS again. Conclusion During the RNS therapeutic process the u- tility of mycophenolate mofetil coming with prednisone could effectly relieve the patient＇ s disease as well as re- duces the reoccurrence rates to much extent. In addition ,with minor side effects this method should gradually be- come one of the chief treatments in oatients with RNS.
出处
《继续医学教育》
2013年第9期18-20,共3页
Continuing Medical Education
关键词
难治性肾病综合征
吗替麦考酚酯
环磷酰胺
泼尼松
Refractory nephrotic syndrome （RNS）
Mycophenolate mofetil
Cyelophosphamide
Predni-sone
