吗替麦考酚酯治疗重型IgA肾病的临床疗效分析

目的:探讨吗替麦考酚酯(MMF)治疗重型IgA肾病的疗效.方法:32例肾活检诊断为IgA肾病的肾组织病理Lee's分级在Ⅲ级以上.使用MMF治疗,观察指标为尿蛋白定量、尿沉渣、血清肌酐及血白蛋白.结果:治疗3个月尿蛋白降低(2.05±0.46)g/24h vs(3.40±1.52)g/24h,P＜0.05,治疗12个月后尿蛋白明显降低(0.92±0.43)g/24h,P＜0.05,血白蛋白明显升高(45.3+4.7)g/24h vs (35.2±5.2)g/24h,P＜0.05;完伞缓解率37.5%,总有效率87.5%.MMF治疗后尿沉渣亦逐步改善.结论:MMF治疗对于Lee's分级Ⅲ级以上IgA肾病,降低尿蛋白、改善肾功能有确切疗效.

Efficacy analysis of mycophenolate mofeil in treating advanced IgA nephropathy

Objective：To investigate the efficiency of mycophenolate mofeil（MMF） in treating advanced IgA nephropathy.Methods：Thirty-two patients with IgA nephropathy diagnosed by kidney biopsy were enrolled and their renal histological scores were all Lee＇s III or more than Lee＇s Ⅲ.The patients were treated with MMF for at least one year and the changes of urinary protein excretion,urinary sediment,serum albumin and creatinine were observed as statistic parameters.Results：After three months treatment,urinary protein excretion decreased significantly（2.05±0.46 vs.3.40±1.52,P0.05）.After one year,urinary protein continuously decreased to 0.92±0.43（P0.05）,and serum albumin was increased from 35.2±5.2 to 45.3±4.7（P0.05）.The complete remission rate was 37.5% and the total effective rate was 87.5%.Urinary sediment as also gradually improved.Conclusion：MMF is effective to reduce urinary protein and improve the renal function in the treatment of advanced IgA nephropathy.