霉酚酸酯联合强的松治疗狼疮性肾炎临床研究

目的 观察霉酚酸酯（骁悉）联合强的松治疗LN的临床疗效和不良反应。方法 43例狼疮性肾炎随机分为骁悉联合强的松和环磷酰胺联合强的松治疗组，采用ELISA，间接免疫荧光法，生化法等检测两组病人血清细胞因子IL-6，IL-8，TNF-α水平，自身抗体，补体C3，C4，肝功，肾功和尿蛋白等指标。结果 与环磷酰胺联合强的松治疗相比，病人经骁悉联合强的松治疗后血清IL-6，IL-8，TNF-α水平，抗核抗体，A-dsDNA抗体水平，血尿素氮，肌酐以及尿蛋白水平均明显降低；血C3，C4增高更为明显，且病人无明显的骨髓抑制和肝功能损害。结论 骁悉联合强的松治疗狼疮性肾炎疗效好。安全性高，值得推广应用。

Clinical study of mycophenolate mofetil plus prednisone in patients with lupus nephritis

Objective To observe the clinical efficacy and toxicity of mycophenolate mofetil(MMF) plus prednisone in patients with lupus nephritis(LN).Methods Forty-three patients with LN were divided into the MMF plus prednisone group and the cyclophosphamide(CYP) plus prednisone group.The serum levels of IL-6,IL-8 and TNF-alpha were measured using ELISA.The antinuclear antibodies were analysized by indirect immunofluorescence(ANA) and serum anti-dsDNA antibodies by ELISA.Changes of levels of serum blood urea nitrogen,creatinine,C 3,C 4,transaminase activities as well as urinary protein excretion were also observed and compared.Results Compared with CYP plus prednisone group,MMF plus prednisone treatment markedly decreased levels of serum IL-6,IL-8 and TNF-alpha,suppressed antinuclear and anti-dsDNA antibodies production.MMF plus prednisone treatment significantly deceased levels of serum blood urea nitrogen,creatinine,and urinary protein excretion,increased the levels of serum C 3,C 4.MMF plus prednison therapy,could induce some side effects such as nausea,vomiting,and infection,but no serious side effects including renal damage and liver dysfunction leading to therapy interruption were observed.Conclusion Combination therapy of MMF and prednisone is effective and safe in the treatment of LN,which is worth popularizing in patients with LN.