吗替麦考酚酯联合缬沙坦治疗IgA肾病的临床研究

目的了解吗替麦考酚酯(MFF)、缬沙坦联合小剂量激素,以及单纯激素治疗IgA肾病的疗效。方法经肾穿刺活检并结合临床确诊为原发性IgA肾病39例,随机分成两组,治疗组20例,服用吗替麦考酚酯、缬沙坦及泼尼松;对照组19例,服用泼尼松。结果经治疗24周后,MFF联合缬沙坦治疗组的完全缓解率及总有效率分别为45%和85%,单纯激素组分别为31.6%和73.7%;48周后,治疗组完全缓解率及总有效率分别为50%和90%。对照组分别为35.3%和76.5%。治疗24、48周后单纯激素组的复发率分别为5.3%、17.6%,治疗组为0。MEF及缬沙坦治疗组的完全缓解率、总有效率及复发率与单纯激素组相比其差异有统计学意义(P<0.05)。结论 MFF联合缬沙坦及小剂量激素治疗IgA肾病效果好,复发率低,不良反应少。

Clinic Effect of Mycophenolate Mofetil combined Valsartan on IgA Nephropathy

Objective To investigate the effectiveness and safety of Mycophenolate mofetil（MFF）combined valsartan and small dose of hormones,and standard hormone treatment of IgA nephropathy.Method 39 IgA nephropathy patients which were confirmed by renal biopsy,were randomly divided into experimental and control groups.Experimental group included 20 Cases who were treated with mycophenolate mofetil,valsartan and low-dose prednisone;Control group enrolled 19 cases who were given standard prednisone.Results The complete remission rate and total effective rate at the 24 and 48 weeks after MMF combined valsartan and low-dose predisone therapy was 45%,85%,50%and 90%,and only 31.6%,73.7%,35.3%and 76.5%respectively in control group.After treatment of 24 and 48 weeks,the recurrence rate in standard hormone group was 5.3%,17.6%,and only 0 in experimental group.The differences in complete remission rate,total effective rate and recurrence rate between experimental and control group were statistically significant（P〈0.05）. Conclusions MFF combined valsartan and low-dose hormone is a safe and efective medicine in treatment of IgA nephropathy.