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目的 观察吗替麦考酚酯(MMF)联合甲泼尼龙(MP)冲击治疗重症过敏性紫癜性肾炎(HSPN)的疗效.方法 选择重症HSPN患儿15例,给予MMF及MP冲击治疗,随访6月~2年.观察15例患儿的临床疗效、治疗前后患儿24 h尿蛋白量、尿β2M、血浆白蛋白、血肌酐的水平变化及不良反应发生情况.结果 治疗总有效率为80.0%.随访6月~2年,完全缓解7例中停用MMF 4例,维持缓解3例.治疗后患者24 h尿蛋白量、尿β2M、血肌酐水平低于治疗前,血浆白蛋白高于治疗前,差异均有统计学意义(P<0.05或P<0.01).结论 MMF联合MP治疗重症HSPN近期疗效好,不良反应少,是临床治疗重症HSPN的有效方案.“,”Objective To observe the effet of mycophenolate mofetil(MMF)combined with methylprednisolone(MP) on severe Henoch-Schonlein purpura nephritis(HSPN).Methods 15 children with severe HSPN were treated by MMF combined with MP.All patients had been followed up for 6 months to 2 years.The clinical efficacy,24 hours urine protein,urineβ2M,plasma albumin,serum creatinine levels before and after the treatment and adverse reactions of 15 patients were observed.Results The total effective rate was 80.0%.All patients were followed up for 6 months to 2 years,in 7 patients with complete remission,4 patients discontinued MMF,and the other 3 patients were relieved.After treatment,24 hours urine protein,urine β2M,serum creatinine levels were lower than before treatment,plasma albumin was higher than before treatment,the differences were statistically significant(P<0.05 or P<0.01).Conclusion MMF combined with MP has better short-time effect and few side-effects on severe HSPN.It is an important treatment of severe HSPN.