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目的通过霉酚酸酯(MMF)在难治性肾病综合征的临床疗效观察,探讨MMF治疗难治性肾综的适应症。方法经肾活检及临床诊断为难治性肾综患者21例,观察MMF治疗后第4周、8周、12周及16周各项临床指标变化,对其疗效进行评价。结果 MMF能有效降低难治性肾综患者24小时尿蛋白总量(P<0.01),血清白蛋白水平上升(P<0.01)。总有效率为85.7％。MCD和MesPGN对MMF反应良好(有效率100％),FSGS和MN疗效较差,3例(3/5)无效。所有病例对MMF有良好耐受性。结论 MMF能有效缓解难治性肾综,疗效良好。
Objective To investigate the clinical efficacy of mycophenolate mofetil (MMF) in the treatment of refractory nephrotic syndrome and to explore the indications of MMF in refractory nephrotic syndrome. Methods Twenty-one patients with refractory nephrotic syndrome who were diagnosed by renal biopsy and clinically were enrolled in this study. The changes of clinical indexes at the 4th, 8th, 12th and 16th week after MMF treatment were observed and evaluated. Results MMF could effectively reduce 24-hour urinary protein (P <0.01) and serum albumin level (P <0.01) in refractory renal allograft patients. The total effective rate was 85.7%. MCD and MesPGN responded well to MMF (effective rate was 100%), FSGS and MN were less effective, and 3 (3/5) were ineffective. All cases were well tolerated with MMF. Conclusion MMF can effectively alleviate refractory renal failure and has good curative effect.