吗替麦考酚酯联合泼尼松治疗老年难治性肾病综合征的临床分析

目的 观察吗替麦考酚酯联合泼尼松治疗老年难治性肾病综合征的临床疗效.方法 67例老年难治性肾病综合征患者按随机数字表法分为两组,观察组35例采用泼尼松联合吗替麦考酚酯治疗,对照组32例采用泼尼松联合环磷酰胺治疗,观察比较两组的临床疗效、尿蛋白定量、血肌酐和血尿酸水平的变化及不良反应.结果 对照组总有效率68.8％( 22/32),观察组总有效率74.3％( 26/35),两组比较差异无统计学意义(P＞0.05).与治疗前比较,两组治疗后尿蛋白定量、血肌酐和血尿酸水平明显下降(P＜0.05),但两组治疗后尿蛋白定量、血肌酐和血尿酸水平比较差异无统计学意义(P＞0.05).观察组的不良反应发生率明显低于对照组(P＜0.05).结论 吗替麦考酚酯联合泼尼松治疗老年难治性肾病综合征患者疗效显著,并且不良反应少,值得临床推广应用.

Clinical analysis of mycophenolate mofetil combined with prednisone in treatment of old patients with refractory nephrotic syndrome

Objective To observe the effect ofmycophenolate mofetil combined with prednisone in treatment of old patients with refractory nephrotic syndrome.Methods From June 2009 to June 2010,67cases of old patients with refractory nephrotic syndrome were divided into two groups by random digits table,32 cases in control group were treated with cyclophosphamide combined with prednisone and 35 cases in observation group were treated with mycophenolate mofetil combined with predrisone.The clinical effect and the levels of urinary protein,serum creatinine and serum uric acid between two groups were compared.Results There was no significant difference in total effective rate between two groups 68.8％(22/32) vs.74.3％ (26/35)] (P ＞ 0.05 ).After treatment,the levels of urinary protein,serum creatinine and serum uric acid in two groups were decreased (P＜ 0.05 ),but there were no significant differences between two groups (P ＞ 0.05 ).The adverse reaction rate in observation group was significantly lower than that in control group (P ＜ 0.05).Conclusion Mycophenolate mofetil combined with prednisone in treatment of old patients with refractory nephrotic syndrome has good effect and low adverse reaction,and it can be applied in clinic.