吗替麦考酚酯联合激素治疗膜性肾病临床对照观察

目的观察吗替麦考酚酯（MMF）联合激素治疗膜性肾病的临床疗效及安全性。方法将40例临床表现为肾病综合征肾活检明确为原发性膜性肾病（PMN）的患者随机分为两组。MMF治疗组采用MMF联合泼尼松龙治疗：环磷酰胺（CTX）对照组采用间断静脉CTX冲击联合泼尼松龙治疗：动态观察疗效及不良反应发生情况。结果经过6个月和12个月的治疗，与治疗前相比，两组尿蛋白均显著下降（P〈0．05），血浆清蛋白均显著回升（P〈0．05），血总胆固醇均显著下降（P〈0．05），治疗12个月时，MMF治疗组完全缓解率和总有效率分另1为20％和60％，CTX对照组分别为20％和55％。两组间相同时间观察指标比较差异无统计学意义（P〉0．05）。MMF治疗组发生胃肠道症状及转氨酶升高各1例，而CTX对照组发生肺部感染、带状疱疹及闭经各1例，胃肠道症状2例，白细胞减少、转氨酶升高各3例，MMF治疗组不良反应发生轻微，且不良反应发生率明显低于CTX对照组（P〈0．05）。结论MMF联合激素治疗膜性肾病的疗效与环磷酰胺联合激素治疗的疗效相同，但MMF治疗的不良反应小，耐受性好。

Clinical trial on the effect of mycophenolate mofetil and prednisone in treating primary membranous nephropathy

Objective To investigate the efficacy and safety of mycophenolate mofetil(MMF)combined prednisone in the treatment of primary membranous nephropathy(PMN).Methods Forty patients with PMN were divided into two groups at random.Patients in the test group received MMF and prednisone.Patients in the control group received Cyclophosphamide(CTX)and prednisone.Clinical data were observed in the 6th and 12th month.Results After receiving MMF therapy in the test group,the proteinuria was decreased significantly(P<0.0...