吗替麦考酚酯联合糖皮质激素治疗特发性膜性肾病的疗效观察(1)
摘 要：目的 比較吗替麦考酚酯和环磷酰胺治疗特发性膜性肾病的有效性及安全性。方法 选择2011年8月～2013年8月在遂宁市中心医院确诊为特发性膜性肾病的患者40例，随机分为吗替麦考酚酯治疗组和环磷酰胺治疗组，各20例，分别给予吗替麦考酚酯和环磷酰胺联合糖皮质激素治疗。在治疗后6、12、24和36个月，检测两组患者尿蛋白定量、血清白蛋白、血肌酐、内生肌酐清除率、胆固醇及甘油三酯，同时观察并记录两组患者不良反应情况。结果 治疗12个月后，两组患者尿蛋白定量、血清白蛋白、血肌酐及胆固醇水平较治疗前均改善，但两组间比较差异无统计学意义(P>0.05)。治疗24月后，MMF组患者尿蛋白定量、血清白蛋白、胆固醇及甘油三酯分别为(1.19±5.15)g/24h、(40.14±3.96)g/L、(4.73±0.64)mmol/L和(1.88±0.28)mmol/L，而CTX组患者相应指标为(1.82±0.94)g/24h、(36.05±3.52)g/L、(5.33±0.76)mmol/L和(2.13±0.29)mmol/L，两组患者数据比较，差异具有统计学意义(P<0.05)。两组患者蛋白尿总缓解率在36个月后分别为90.00%和80.00%，差异无统计学意义(P>0.05)。两组患者在药物不良反应比较，差异无统计学意义(P>0.05)。结论 吗替麦考酚酯联合糖皮质激素治疗特发性膜性肾病疗效肯定，和环磷酰胺相比，其降尿蛋白效果更佳，同时药物不良反应更少。
, 百拇医药
关键词：特发性膜性肾病；吗替麦考酚酯；糖皮质激素；环磷酰胺
中图分类号：R692.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.22.024
文章编号：1006-1959(2018)22-0089-04
Therapeutic Effect of Mycophenolate Mofetil Combined with Glucocorticoid on Idiopathic Membranous Nephropathy
CHEN Xiao-xia，TANG Yong，HU Qing，WANG Mao-he
(Department of Nephrology，Suining Central Hospital，Suining 629000，Sichuan，China)
, 百拇医药
Abstract：Objective To compare the efficacy and safety of mycophenolate mofetil and cyclophosphamide in the treatment of idiopathic membranous nephropathy.Methods A total of 40 patients with idiopathic membranous nephropathy diagnosed in Suining Central Hospital from August 2011 to August 2013 were randomly divided into the mycophenolate mofetil treatment group and the cyclophosphamide treatment group， 20 cases each. Treatment with mycophenolate mofetil and cyclophosphamide in combination with glucocorticoids. At 6， 12， 24， and 36 months after treatment， urine protein quantitation， serum albumin， serum creatinine， endogenous creatinine clearance， cholesterol， and triglycerides were measured in both groups， and adverse events were observed and recorded in both groups.Results After 12 months of treatment， urine protein quantitation， serum albumin， serum creatinine and cholesterol levels were improved in both groups， but there was no significant difference between the two groups(P>0.05). After 24 months of treatment， urine protein quantitation， serum albumin， cholesterol and triglycerides in the MMF group were (1.19±5.15) g/24h， (40.14±3.96) g/L， (4.73±0.64) mmol/L， and (1.88±0.28) mmol/L， and the corresponding indicators of patients in the CTX group were (1.82±0.94) g/24h， (36.05±3.52) g/L，(5.33±0.76) mmol/L and (2.13±0.29) mmol/L， comparison of data between the two groups， the difference was statistically significant(P<0.05). The total proteinuria remission rate in the two groups was 90.00% and 80.00% after 36 months， the difference was not statistically significant(P>0.05). There were no significant differences in adverse drug reactions between the two groups(P>0.05). Conclusion The efficacy of mycophenolate mofetil combined with glucocorticoid in the treatment of idiopathic membranous nephropathy is more effective than cyclophosphamide， and it has better urinary protein lowering effect and less adverse drug reactions., http://www.100md.com(陈晓霞 唐勇 胡庆)
, 百拇医药
关键词：特发性膜性肾病；吗替麦考酚酯；糖皮质激素；环磷酰胺
中图分类号：R692.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.22.024
文章编号：1006-1959(2018)22-0089-04
Therapeutic Effect of Mycophenolate Mofetil Combined with Glucocorticoid on Idiopathic Membranous Nephropathy
CHEN Xiao-xia，TANG Yong，HU Qing，WANG Mao-he
(Department of Nephrology，Suining Central Hospital，Suining 629000，Sichuan，China)
, 百拇医药
Abstract：Objective To compare the efficacy and safety of mycophenolate mofetil and cyclophosphamide in the treatment of idiopathic membranous nephropathy.Methods A total of 40 patients with idiopathic membranous nephropathy diagnosed in Suining Central Hospital from August 2011 to August 2013 were randomly divided into the mycophenolate mofetil treatment group and the cyclophosphamide treatment group， 20 cases each. Treatment with mycophenolate mofetil and cyclophosphamide in combination with glucocorticoids. At 6， 12， 24， and 36 months after treatment， urine protein quantitation， serum albumin， serum creatinine， endogenous creatinine clearance， cholesterol， and triglycerides were measured in both groups， and adverse events were observed and recorded in both groups.Results After 12 months of treatment， urine protein quantitation， serum albumin， serum creatinine and cholesterol levels were improved in both groups， but there was no significant difference between the two groups(P>0.05). After 24 months of treatment， urine protein quantitation， serum albumin， cholesterol and triglycerides in the MMF group were (1.19±5.15) g/24h， (40.14±3.96) g/L， (4.73±0.64) mmol/L， and (1.88±0.28) mmol/L， and the corresponding indicators of patients in the CTX group were (1.82±0.94) g/24h， (36.05±3.52) g/L，(5.33±0.76) mmol/L and (2.13±0.29) mmol/L， comparison of data between the two groups， the difference was statistically significant(P<0.05). The total proteinuria remission rate in the two groups was 90.00% and 80.00% after 36 months， the difference was not statistically significant(P>0.05). There were no significant differences in adverse drug reactions between the two groups(P>0.05). Conclusion The efficacy of mycophenolate mofetil combined with glucocorticoid in the treatment of idiopathic membranous nephropathy is more effective than cyclophosphamide， and it has better urinary protein lowering effect and less adverse drug reactions., http://www.100md.com(陈晓霞 唐勇 胡庆)