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目的观察吗替麦考酚酯与激素联合治疗膜性肾病的临床效果。方法选取河南大学淮河医院肾内科收治的47例膜性肾病患者作为研究对象,随机分为观察组与对照组。观察组27例患者采用吗替麦考酚酯联合激素治疗,对照组20例患者采用环磷酰胺联合激素治疗,分别于治疗前,治疗6个月后测量患者血肌酐、血白蛋白、24 h尿蛋白及血低密度脂蛋白。采用SPSS 13.0软件进行数据分析,计量资料用(xˉ±s)表示,用t检验,P<0.05为差异有统计学意义。结果两组患者治疗后血肌酐上升、血白蛋白与下降血低密度脂蛋白,与治疗前相比差异有统计学意义(均P<0.05),两组患者治疗后,24 h尿蛋白虽有所下降,但差异无统计学意义(P>0.05)。观察组患者不良反应率为3.70%,对照组为25.00%,差异有统计学意义(P<0.05)。结论吗替麦考酚酯与环磷酰胺治疗膜性肾病疗效相似,但吗替麦考酚酯不良反应较少,是更理想的治疗方案。
Objective To observe the clinical effect of mycophenolate mofetil and hormones in the treatment of membranous nephropathy. Methods Forty-seven patients with membranous nephropathy admitted to Department of Nephrology, Huaihe Hospital, Henan University were enrolled in this study. They were randomly divided into observation group and control group. Twenty-seven patients in the observation group were treated with mycophenolate mofetil and hormone therapy. In the control group, 20 patients were treated with cyclophosphamide and hormone therapy. Before treatment and 6 months after treatment, serum creatinine, serum albumin, Urine protein and blood low-density lipoprotein. SPSS 13.0 software was used for data analysis, measurement data (xˉ ± s) that with t test, P <0.05 for the difference was statistically significant. Results After treatment, the serum creatinine increased, serum albumin and blood-lipid-low density lipoprotein decreased after treatment in both groups (all P <0.05). After treatment, 24 h urinary protein Decreased, but the difference was not statistically significant (P> 0.05). Adverse reaction rate was 3.70% in the observation group and 25.00% in the control group, the difference was statistically significant (P <0.05). Conclusion Mycophenolate mofetil and cyclophosphamide in the treatment of membranous nephropathy have similar effects, but the mycophenolate mofetil has fewer adverse reactions, which is a more ideal treatment.