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目的观察霉酚酸酯(MMF)联合甲泼尼龙、拉米夫定治疗乙型肝炎病毒相关性肾炎的疗效及安全性。方法选出1999-01～2004-01中山大学附属第三医院24例乙型肝炎病毒相关性肾炎达到肾病综合征诊断标准的患者,给予霉酚酸酯1.0～1.5g/d联合甲泼尼龙0.4mg/(kg·d)及拉米夫定0.1g/d治疗6个月,每2周复查尿常规、尿蛋白定量、血常规、血清白蛋白、肝肾功能、HBV-DNA定量。结果治疗后9例完全缓解,11例部分缓解,4例无效。所有患者治疗后未出现明显肝肾功能损害、骨髓抑制等不良反应,未发现病毒复制增加。结论MMF联合甲泼尼龙、拉米夫定治疗乙型肝炎病毒相关性肾炎有效。
Objective To observe the efficacy and safety of mycophenolate mofetil (MMF) combined with methylprednisolone and lamivudine in the treatment of hepatitis B virus-associated nephritis. Methods From January 1999 to January 2004, 24 patients with hepatitis B virus-associated nephritis who reached the diagnostic criteria of nephrotic syndrome in the Third Affiliated Hospital of Sun Yat-sen University were enrolled. Patients were treated with mycophenolate mofetil 1.0 ~ 1.5g / d and methylprednisolone 0.4 Urine routine examination, urinary protein, blood routine, serum albumin, liver and kidney function and HBV-DNA quantitation were performed every two weeks for 6 months after treatment with 0.1 mg / (kg · d) of lamivudine and 0.1 g / d of lamivudine. Results After treatment, 9 cases were completely relieved, 11 cases partially relieved, and 4 cases were ineffective. All patients did not show significant liver and kidney dysfunction after treatment, bone marrow suppression and other adverse reactions, no increase in viral replication was found. Conclusion MMF plus methylprednisolone and lamivudine are effective in treating hepatitis B virus-associated nephritis.