吗替麦考酚酯治疗原发性膜性肾病的临床疗效

目的考察吗替麦考酚酯对原发性膜性肾病患者的作用，探讨吗替麦考酚酯治疗原发性膜性肾病的临床疗效和安全性。方法将68例肾活检诊断为原发性膜性肾病的患者，随机分为治疗组和对照组，治疗组给予吗替麦考酚酯、强的松进行治疗，对照组给予环磷酰胺、强的松进行治疗，随访12个月，监测患者血肌酐、血清白蛋白、24h尿蛋白定量等主要生理指标，考察总有效率及不良反应。结果经治疗6、12个月，治疗组总有效率分别为61．8％、73．5％，对照组总有效率分别为47．1％、58．8％，与治疗前相比，2组差异均有统计学意义（P〈0．05）；治疗6、12个月后，与对照组相比，治疗组患者的血清蛋白含量明显升高，24h尿蛋白量及血肌酐含量均显著降低（P〈0．05）；其它各项生理指标均基本正常，未发生严重的不良反应。结论吗替麦考酚酯联合强的松治疗原发性膜性肾病临床疗效较好，不良反应少，可作为临床治疗原发性膜性肾病的方案之一，具有一定的推广价值。

Investigate on the clinical efficacy of idiopathic membranous treatment with nephropathy mycophenolate mofetil

Abstract： Objective Study the role of Membranous nephropathy in patients with primary with the treatment of Mycophe- nolate mofetil, and to investigate Mycophenolate mofetil Prednisone idiopathic membranous nephropathy clinical efficacy and safety. Methods 68 patients with biopsy diagnosis of idiopathic membranous nephropathy were randomly divided into treatment group and control group,the treatment group received Mycophenolate mofetil,prednisone treatment, control group was given Cyclophosphamide, prednisone treatment, follow-up of 12 months, monitoring of key physiological indicators ex- amined the total efficiency and adverse reactions. Results 6 and 12 months after treatment, in the treatment group, the total effective rate was 61.8% and 73.5% in the control group,the total effective rate was 47.1% and 58.8% ,compared with before treatment,the two groups were significantly different（ P 〈 0.05 ） ;6 and 12 months after treatment, compared with before treatment, the two groups were significantly elevated serum protein levels,24 h urine protein and serum creati- nine levels were significantly lower, with a significant difference （P 〈 0.05 ） ;various other physiological indicators were normal, no serious adverse reactions occurred. Conclusion Mycophenolate mofetil Prednisone idiopathic membranous ne- phropathy had better clinical efficacy, with less adverse reactions, it can be used as clinical treatment of idiopathic mem- branous nephropathy one of the options, with some promotional value.