中华医学杂志（英文版）2002，Vol.115Issue(5)：705-709,5.
霉酚酸酯与间断环磷酰胺静脉冲击疗法治疗弥漫增生型狼疮性肾炎疗效的比较
Mycophenolate mofetil vs cyclophosphamide therapy for patients with di ffuse proliferative lupus nephritis
胡伟新 1陈惠萍 1唐政 1王庆文 1沈克勤 1刘志红 1黎磊石1
作者信息
- 1. 南京军区南京总医院,解放军肾脏病研究所,南京大学医学院临床学院,南京,210002
- 折叠
摘要
Abstract
Objective To make an open label prospective trial for comparing the therapeutic effects of mycophenolate mofetil (MMF) vs cyclophosphamide (CYC) pulse therapy on patients with diffuse proliferative lupus nephritis (DPLN).Methods Forty-six patients with biopsy proven active DPLN were enrolled in this study. Twenty-three patients were given MMF orally at a dosage of 1.0-1.5 g/d (MMF Group). Another 23 cases received conventional intermittent CYC pulse therapy ( CYC Group). Supplemental steroid treatment was offered in the same manner to bo th groups. The age, sex distribution and severity of renal damage were matched in two groups. Therapeutic effects were evaluated at the end of six-month trea tment. Fifteen patients in the MMF Group and 12 patients in the CYC Group had r epeated renal biopsy at that time. Results MMF therapy was more effective in reducing proteinuria and hematuria. A 50% red uction of urinary protein and urinary red blood cell excretion from baseline val ue in 69.6% and 91.3% patients in the MMF Group, while only 47.8% and 65.2% in the CYC Group. MMF was more effective in inhibiting autoantibody production (especially anti-dsDNA antibody) and in decreasing serum cryoglobulin levels. Pathologically, the MMF group showed more markedly reduction in glomerular immun e deposits with less glomerular necrosis, and less microthrombi, less crescent f ormation and vascular changes in the repeated renal biopsy as compared with the CYC group. Adverse reactions related to the treatment included gastrointestinal symptoms 26.1% and 43.5% in the MMF and CYC Groups respectively, infection 17 .4% in the MMF group and 30.4% in the CYC group. Conclusion MMF was more effective in controlling the clinical activity of DPLN and renal v ascular lesions as compared with CYC pulse therapy in a 6 month follow-up study . 关键词
狼疮性肾炎/环磷酰胺/霉酚酸酯Key words
lupus nephritis cyclophosphamide mycophenolate mofetil分类
医药卫生引用本文复制引用
胡伟新,陈惠萍,唐政,王庆文,沈克勤,刘志红,黎磊石..霉酚酸酯与间断环磷酰胺静脉冲击疗法治疗弥漫增生型狼疮性肾炎疗效的比较[J].中华医学杂志（英文版）,2002,115(5):705-709,5.
