吗替麦考酚酯联合氟伐他汀治疗原发性难治性肾病综合征的效果观察

目的 观察吗替麦考酚酯（MMF）联合氟伐他汀治疗原发性难治性肾病综合症（IRNS）的临床效果.方法 将62例IRNS患者随机分为治疗组和对照组两组,每组各31例,治疗组采用MMF联合联合氟伐他汀治疗,对照组采用环磷酰胺（CTX）间断静脉冲击联合口服甲泼尼松龙治疗.比较两组缓解率、副作用发生率及复发率.结果 治疗组的完全缓解率、显著缓解率及总缓解率（51.6％,25.8％,87.1％）均显著高于对照组（35.5％,16.1％,67.7％）（P＜0.05）;治疗组尿蛋白下降及血浆白蛋白回升的程度与对照组比较,差异有统计学意义（P＜0.01）.治疗组的副作用发生率及复发率（12.9％,12.9％）均显著低于对照组（54.8％,32.3％）（P＜0.01）.结论 与CTX静脉冲击疗法比较,MMF联合氟伐他汀治疗IRNS缓解率高,能更有效地降低尿蛋白含量,副作用发生率和复发率低,是目前治疗IRNS的一种较好方法.

Mycophenolate mofetil combined with fluvastatin in the treatment of idiopathic refractory nephrotic syndrome

Objective To observe the clinical efficacy of mycophenolate mofetil（MMF） combined with fluvastatin in the treatment of idiopathic refractory nephrotic syndrome （IRNS）. Methods 62 patients with IRNS were enrolled into this study,they were divided into treatment group（n=31） and control group（n=31）.Treatment group was treated with MMF and fluvastatin;control group was given with cyclophosphamide and prednisone.The remission rate,drug-related side effect and recurrence rate were compared between the two groups. Results The complete remission rate,remission rate and to- tal remission rate of treatment group （51.6%,25.8%,87.1%） were all significantly higher than those of matched group （35.5%,16.1%,67.7%）（P〈0.05）.The treatment group showed decreased the quantity of urinary protein and increased of serum albumin as compared with control group with statistical significance （P〈0.01）;the adverse reactions rate and re- currence rate of treatment group（12.9%,12.9%） were all significantly lower than those of control group（54.8%,32.3%）（P〈 0.01）. Conclusion The combination therapy of MMF and fluvastatin was more effective than CTX pulse and oral pred- nisone therapy in patients with IRNS.MMF and fluvastatin is effective in reducing proteniuria with fewer side effect and lower recurrence rate,which is a good method for the treatment of IRNS.