霉酚酸酯联合糖皮质激素诱导治疗过敏性紫癜性肾炎的回顾性研究（英文）
发布时间：2018-07-16 13:07
【摘要】：目的:合并中等量蛋白尿的过敏性紫癜性肾炎的诱导治疗尚无确切方案,本研究通过回顾性比较分析了霉酚酸酯联合糖皮质激素的疗效与安全性。创新点:首次对霉酚酸酯联合糖皮质激素诱导治疗过敏性紫癜性肾炎进行了回顾性研究。方法:回顾性分析2007年1月至2013年6月间在浙江大学附属第一医院肾脏病中心接受肾穿刺活检,且经过3个月以上血管紧张素转换酶抑制剂(ACEI)/血管紧张素受体拮抗剂(ARB)治疗后蛋白尿为1.0~3.5 g/24 h的过敏性紫癜性肾炎患者95例。根据治疗方案分为3组,霉酚酸酯组(33例)在原剂量ACEI/ARB的基础上加用霉酚酸酯联合低剂量糖皮质激素,糖皮质激素组(31例)在原剂量ACEI/ARB的基础上加用全剂量糖皮质激素,对照组(31例)维持单用ACEI/ARB治疗,但可提高其剂量。患者随访观察6~78月(中位观察时间28月),霉酚酸酯组、糖皮质激素组与对照组的蛋白尿缓解率分别为72.7%、64.5%与45.2%(图1),发生副作用分别为17例、30例与6例,糖皮质激素组高脂血症与高血压发生率较高(表3)。结论:霉酚酸酯联合低剂量糖皮质激素可有效诱导缓解过敏性紫癜性肾炎,其缓解率与全剂量糖皮质激素治疗相当,且副作用较少。
[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.
【作者单位】： 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
【分类号】：R692.34
[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.
【作者单位】： 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
【分类号】：R692.34
【共引文献】
相关期刊论文 前10条
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2 王兆康;;糖皮质激素防止过敏性紫癜肾脏受累的疗效观察[J];儿科药学杂志;2010年03期
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