霉酚酸酯治疗难治性狼疮肾炎的疗效观察

[目的]比较霉酚酸酯(mycophenolate mofetil ,MMF)与间断性环磷酰胺(cyclophosphamide ,CTX)静脉冲击疗法治疗狼疮肾炎(lupus nephritis ,LN)的近期及远期疗效、不良反应及安全性.[方法]CTX组:间断性环磷酰胺冲击疗法联合激素治疗31例LN患者.MMF组:M...

Observation on the Efficacy of Mycophenolate Mofetil for the Treatment of Refractory Lupus Nephritis

[Objective] To compare the short term and long term efficacy, adverse reactions and safety of mycophenolate mefetil（MMF） vs. intermittent intravenous pulse therapy with eyclophosphamide（CTX） for the treatment of lupus nephritis（LN）. [Methods]CTX group（n= 31） was given intravenous CTX pulse therapy and prednisone. MMF group（n=31） was given MMF and prednisone. The patients in two groups had the similar pathology type and condition. Patients in MMF group were refractory to CTX therapy. [Resultsl Both CTX and MMF for the treatment of LN reduced proteinuria, improved renal function and increased plasma albumin, but there was no significant difference between the two group. The mean course of treatment of MMF group was significantly longer than that of CTX group, but the outcome of two groups was similar. Liver toxicity and leukopenia were not observed, while infections （ 16. 1 % ）, herpes zoster （3.2% ） and gastrointestinal symptom（25.8% ） were found during MMF treatment. In CTX group, liver toxicity（25.8 %）, infections（29. 0 % ）, leukopenia（ 12.9 % ） and gastrointestinal symptom（6.5 % ） were observed. There was significant difference in gastrointestinal symptom and liver toxicity between two groups（ P 〈0.05）. [Conclusion] Both CTX and MMF for the treatment of LN are effective, but there is no significant difference between them. MMF is predominant for the treatment of LN patients who are refractory to CTX combined with prednisone and have a long course of disease and protracted condition, and it has the same effect as CTX.