【摘要】：目的:合并中等量蛋白尿的過敏性紫癜性腎炎的誘導(dǎo)治療尚無確切方案,本研究通過回顧性比較分析了霉酚酸酯聯(lián)合糖皮質(zhì)激素的療效與安全性。創(chuàng)新點:首次對霉酚酸酯聯(lián)合糖皮質(zhì)激素誘導(dǎo)治療過敏性紫癜性腎炎進行了回顧性研究。方法:回顧性分析2007年1月至2013年6月間在浙江大學(xué)附屬第一醫(yī)院腎臟病中心接受腎穿刺活檢,且經(jīng)過3個月以上血管緊張素轉(zhuǎn)換酶抑制劑(ACEI)/血管緊張素受體拮抗劑(ARB)治療后蛋白尿為1.0~3.5 g/24 h的過敏性紫癜性腎炎患者95例。根據(jù)治療方案分為3組,霉酚酸酯組(33例)在原劑量ACEI/ARB的基礎(chǔ)上加用霉酚酸酯聯(lián)合低劑量糖皮質(zhì)激素,糖皮質(zhì)激素組(31例)在原劑量ACEI/ARB的基礎(chǔ)上加用全劑量糖皮質(zhì)激素,對照組(31例)維持單用ACEI/ARB治療,但可提高其劑量。患者隨訪觀察6~78月(中位觀察時間28月),霉酚酸酯組、糖皮質(zhì)激素組與對照組的蛋白尿緩解率分別為72.7%、64.5%與45.2%(圖1),發(fā)生副作用分別為17例、30例與6例,糖皮質(zhì)激素組高脂血癥與高血壓發(fā)生率較高(表3)。結(jié)論:霉酚酸酯聯(lián)合低劑量糖皮質(zhì)激素可有效誘導(dǎo)緩解過敏性紫癜性腎炎,其緩解率與全劑量糖皮質(zhì)激素治療相當,且副作用較少。
[Abstract]:Objective: there is no definite treatment for Henoch-Schonlein purpura nephritis with moderate proteinuria. The efficacy and safety of mycophenolate mofetil combined with glucocorticoid were analyzed retrospectively. Innovation: the treatment of Henoch-Schonlein purpura nephritis with mycophenolate mofetil combined with glucocorticoid was reviewed for the first time. Methods: from January 2007 to June 2013, renal biopsy was performed at the first affiliated Hospital of Zhejiang University. 95 patients with Henoch-Schonlein purpura nephritis were treated with angiotensin converting enzyme inhibitor (ACEI) / angiotensin receptor antagonist (ARB) for more than 3 months. The mycophenolate mofetil group (33 cases) was treated with mycophenolate mofetil combined with low-dose glucocorticoid on the basis of the original dose of ACEI / ARB, and the glucocorticoid group (31 cases) was treated with full dose of glucocorticoid on the basis of the original dose of ACEI / ARB. The control group (31 cases) was treated with ACEI / ARB alone, but the dose was increased. The remission rates of proteinuria in mycophenolate mofetil group, glucocorticoid group and control group were 72.5% and 45.2% respectively (fig. 1), and the side effects were 17 cases (30 cases) and 6 cases (6 cases), respectively. The incidence of hyperlipidemia and hypertension was higher in glucocorticoid group (Table 3). Conclusion: mycophenolate mofetil combined with low dose glucocorticoid can effectively induce and relieve Henoch-Schonlein purpura nephritis.
【作者單位】： Kidney
【基金】：supported by the National Key Technology R&D Program of China(No.2013BAI09B04) the Medical Research Funds from the Bureau of Health of Zhejiang Province(No.2013KYA072),China
【分類號】：R692.34

【共引文獻】

相關(guān)期刊論文 前10條

1 丁江華;龔升平;;鹽酸川芎嗪注射液預(yù)防過敏性紫癜性腎炎的臨床研究[J];安徽醫(yī)藥;2007年11期

2 王兆康;;糖皮質(zhì)激素防止過敏性紫癜腎臟受累的療效觀察[J];兒科藥學(xué)雜志;2010年03期

3 吳小川;陳海霞;;兒童過敏性紫癜腎臟損傷的發(fā)病機制及治療[J];兒科藥學(xué)雜志;2012年06期

4 寧發(fā)錦;yの濫，

本文編號：2126483