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目的:观察霉酚酸酯(MMF)治疗小儿频复发肾病综合征的疗效和毒副作用。方法:37例频复发肾病综合征患儿(24例单纯型肾病综合征和13例肾炎型肾病综合征),每日口服MMF(20~30mg/kg),泼尼松(1mg/kg),疗程3~6个月。结果:37例肾病患儿中,24例单纯型肾病经MMF治疗后完全缓解17例(70.8%),部分缓解4例(16.7%),未缓解3例(12.5%);而肾炎型肾病13例经MMF治疗后完全缓解6例(46.2%),部分缓解3例(23.1%),未缓解4例(30.7%)。8例微小病变(MCD)经MMF治疗后均完全缓解;以增生为主要病变的系膜增生性肾小球肾炎(MsPGN)和膜增生性肾小球肾炎(MPGN)共23例,MMF治疗后完全缓解17例(73.9%),部分缓解4例(17.4%),未缓解2例(8.7%)。结论:MMF治疗单纯型肾病综合征频复发病例的效果明显优于肾炎型肾病综合征频复发病例;且对于以增生性病变为主要病理改变的频复发肾病疗效更佳。
Objective: To observe the efficacy and side effects of mycophenolate mofetil (MMF) in the treatment of children with recurrent nephrotic syndrome. Methods: Thirty-seven patients with frequent recurrent nephrotic syndrome (24 cases of simple nephrotic syndrome and 13 cases of nephritis nephrotic syndrome) were given orally daily MMF (20-30 mg / kg), prednisone (1 mg / kg) Course of 3 to 6 months. Results: Of the 37 children with nephrotic syndrome, 24 cases of simple nephropathy were relieved completely by MMF in 17 cases (70.8%), partially relieved in 4 cases (16.7%) and unresponsive in 3 cases (12.5%). Nephritis nephropathy In 6 cases (46.2%) after complete MMF treatment, 3 cases (23.1%) were partly relieved and 4 cases (30.7%) were not relieved. 8 cases of minimal change (MCD) were completely relieved after treatment with MMF; 23 cases were mesangial proliferative glomerulonephritis (MsPGN) and membranoproliferative glomerulonephritis (MPGN) Complete remission in 17 cases (73.9%), partial remission in 4 cases (17.4%), did not relieve in 2 cases (8.7%). Conclusion: MMF is more effective than nephritic nephrotic syndrome in recurrence of nephrotic syndrome. And it is more effective in patients with frequently recurring nephropathy with proliferative lesions as the main pathological changes.