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目的观察原发性局灶节段性肾小球硬化(FSGS)患者应用激素加霉酚酸酯(MMF)治疗的效果。方法对20例FSGS患者用MMF 1.5～2.0 g/d加激素口服治疗3个月后,渐减量至0.5～1.0 g/d维持。半年后测内生肌酐清除率、血清白蛋白,24 h尿蛋白定量,并与同期给予激素治疗的20例患者进行比较。结果激素加霉酚酸酯治疗组6个月后,内生肌酐清除率下降速率较对照组减慢,蛋白尿减少,血清白蛋白上升。结论治疗局灶节段性肾小球硬化,使用激素加霉酚酸酯等药物的疗效优于单独口服足量激素疗法的疗效,可缩短足量激素的疗程,增加FSGS的缓解率,减少激素的不良反应。
Objective To observe the effect of steroid plus mycophenolate mofetil (MMF) in patients with primary focal segmental glomerulosclerosis (FSGS). Methods Twenty patients with FSGS were orally treated with 1.5-2.0 g / d of MMF orally for 3 months and then decreased to 0.5-1.0 g / d. Six months after the measurement of endogenous creatinine clearance, serum albumin, 24 h urine protein quantitation, and with the same period of hormone therapy in 20 patients were compared. Results 6 months after treatment with hormone plus mycophenolate mofetil, the rate of decrease of endogenous creatinine clearance was slower than that of control group, proteinuria was decreased and serum albumin was increased. Conclusions The treatment of focal segmental glomerulosclerosis with glucocorticoids and mycophenolate mofetil is superior to that of oral administration of adequate hormone therapy alone. It can shorten the course of adequate hormones, increase the remission rate of FSGS and decrease the hormones Adverse reactions.