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目的考察吗替麦考酚酯对原发性膜性肾病患者的作用,探讨吗替麦考酚酯治疗原发性膜性肾病的临床疗效和安全性。方法将68例肾活检诊断为原发性膜性肾病的患者,随机分为治疗组和对照组,治疗组给予吗替麦考酚酯、强的松进行治疗,对照组给予环磷酰胺、强的松进行治疗,随访12个月,监测患者血肌酐、血清白蛋白、24 h尿蛋白定量等主要生理指标,考察总有效率及不良反应。结果经治疗6、12个月,治疗组总有效率分别为61.8%、73.5%,对照组总有效率分别为47.1%、58.8%,与治疗前相比,2组差异均有统计学意义(P<0.05);治疗6、12个月后,与对照组相比,治疗组患者的血清蛋白含量明显升高,24 h尿蛋白量及血肌酐含量均显著降低(P<0.05);其它各项生理指标均基本正常,未发生严重的不良反应。结论吗替麦考酚酯联合强的松治疗原发性膜性肾病临床疗效较好,不良反应少,可作为临床治疗原发性膜性肾病的方案之一,具有一定的推广价值。
Objective To investigate the role of mycophenolate mofetil in patients with primary membranous nephropathy and to explore the clinical efficacy and safety of mycophenolate mofetil in the treatment of primary membranous nephropathy. Methods Sixty-eight patients with primary membranous nephropathy diagnosed by renal biopsy were randomly divided into treatment group and control group. The treatment group was given mycophenolate mofetil and prednisone, and the control group was treated with cyclophosphamide Of the pine for treatment, followed up for 12 months to monitor the serum creatinine, serum albumin, 24 h urinary protein and other major physiological indicators to investigate the total effective rate and adverse reactions. Results After treatment for 6 and 12 months, the total effective rates in the treatment group were 61.8% and 73.5%, respectively. The total effective rates in the control group were 47.1% and 58.8% respectively. There were significant differences between the two groups P <0.05). After 6 and 12 months of treatment, the serum protein level of patients in the treatment group was significantly higher than that of the control group, while the proteinuria and serum creatinine in 24 h were significantly decreased (P <0.05) Physiological indicators were normal, no serious adverse reactions. Conclusion Mycophenolate moxifloxacin combined with prednisone treatment of primary membranous nephropathy clinical curative effect is good, less adverse reactions, can be used as a clinical treatment of primary membranous nephropathy program, has some promotional value.