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目的观察新型免疫抑制剂霉酚酸酯 (MMF)联合抗凝、降压治疗慢性原发性肾小球肾炎的疗效和副作用。方法采用MMF、波依定及潘生丁或华法令三联疗法 (Multiplecombinedtherapy)治疗有肾组织纤维化和硬化改变并有进展趋势的慢性原发性肾小球肾炎 ,治疗时间 3- 6个月。结果经三联疗法治疗后 3个月时完全缓解 5例 ,显效或有效 5例 ,治疗前后无变化 1例。 2 4h尿蛋白显著减少 ,由治疗前3.4 3± 1.2 5gh降至 1.2 1± 0 .88g2 4h(P <0 .0 5 )。 3例患者尿蛋白完全转阴 ,血尿亦较治疗前明显减轻。治疗后血清白蛋白由 2 3.4± 4 .5g/L升至 34.6± 5 .8g/L(P <0 .0 5 )。 6例治疗前有肾功能损害患者治疗后 4例肾功能恢复至正常范围。治疗过程中 1例发现WBC减少。结论MMF联合抗凝、降压三联治疗慢性进展性肾小球肾炎显示了较好的近期疗效 ,并有较好的耐受性。
Objective To observe the efficacy and side effects of a novel immunosuppressive agent, mycophenolate mofetil (MMF), in combination with anticoagulation and antihypertensive treatment of chronic primary glomerulonephritis. Methods The treatment of chronic primary glomerulonephritis with fibrosis and sclerosis of renal tissue and the trend of progression was treated with MMF, benazepril and dipyridamole or warfarin triple therapy for 3-6 months. Results 3 months after triple therapy, 5 cases were completely relieved, markedly effective or effective in 5 cases, no change in 1 case before and after treatment. 24 h urinary protein decreased significantly from 3.4 3 ± 1.2 5gh before treatment to 1.2 1 ± 0.88g2 4h (P <0.05). Urinary protein in 3 patients completely negative, hematuria than before treatment significantly reduced. After treatment, serum albumin rose from 23.4 ± 4. 5g / L to 34.6 ± 5. 8g / L (P <0.05). In the 6 patients with renal dysfunction before treatment, 4 cases of renal function returned to normal range after treatment. One case of WBC decreased during treatment. Conclusion MMF combined anticoagulant and antihypertensive triple therapy for chronic progressive glomerulonephritis showed better short-term curative effect and better tolerability.