中国医药
中國醫藥
중국의약
CHINA MEDICINE
2012年
5期
595-597
,共3页
苏勇%陈海燕%刘绛%谭全达
囌勇%陳海燕%劉絳%譚全達
소용%진해연%류강%담전체
膜性肾病%特发性%吗替麦考酚酯%治疗效果%药物不良反应
膜性腎病%特髮性%嗎替麥攷酚酯%治療效果%藥物不良反應
막성신병%특발성%마체맥고분지%치료효과%약물불량반응
Membranous nephropathy,idiopathic%Mycophenolate mofetile%Therapeutic efficacy%Adverse drug reaction
目的 评价吗替麦考酚酯(MMF)联合激素治疗特发性膜性肾病(IMN)的疗效及安全性.方法 46例激素抵抗型IMN患者完全随机分为观察组(23例,MMF+泼尼松口服)和对照组(23例,环磷酰胺静脉滴注+泼尼松口服),疗程12个月.观察患者治疗前、治疗6及12个月尿蛋白、血白蛋白、Cr、TG及TC水平变化,评价治疗疗效及不良反应.结果 观察组治疗6及12个月后尿蛋白[(4.6±2.2)、(3.3±1.5)g/d]、TG[(2.4±1.7)、(2.2±1.3) mmol/L]及TC[(6.5±2.2)、(6.2 ±2.1) mmol/L]较治疗前[(6.8±1.5)g/d、(2.9±1.6) mmol/L、(9.1 ±2.5) mmol/L]明显降低,差异有统计学意义(P＜O.05或P＜O.01)；血白蛋白[(35±5)、(39±4)g/L]较治疗前[(23±5) g/L]明显升高(均P＜0.05)；治疗前后Cr无明显变化[(102±46)、(97±43)、(92±41) μmol/L,P＞O.05].观察组治疗6、12个月各指标与对照组[尿蛋白:(4.8±3.1)、(3.6±2.1)g/d；血白蛋白:(32±5)、(38±5)/L；Cr:(99±41)、(94±38)μmol/L；TG(2.5±1.4)、(2.3±1.6) mmol/L；TC:(6.7±2.7)、(6.3±2.9) mmol/L]比较,差异无统计学意义(均P＞0.05).观察组与对照组患者治疗6及12个月时的总有效率差异无统计学意义[65.2％(15/23)比60.9％( 14/23)、73.9％( 17/23)比69.6％( 16/23),均P＞O.05],但12个月内不良反应发生率[8.7％(2/23)]明显低于对照组[34.8％ (8/23)],差异有统计学意义(P＜0.01).结论 MMF联合激素治疗激素抵抗型IMN在达到相似临床疗效的基础上,副作用小,患者耐受性好,值得进一步深入研究.
目的 評價嗎替麥攷酚酯(MMF)聯閤激素治療特髮性膜性腎病(IMN)的療效及安全性.方法 46例激素牴抗型IMN患者完全隨機分為觀察組(23例,MMF+潑尼鬆口服)和對照組(23例,環燐酰胺靜脈滴註+潑尼鬆口服),療程12箇月.觀察患者治療前、治療6及12箇月尿蛋白、血白蛋白、Cr、TG及TC水平變化,評價治療療效及不良反應.結果 觀察組治療6及12箇月後尿蛋白[(4.6±2.2)、(3.3±1.5)g/d]、TG[(2.4±1.7)、(2.2±1.3) mmol/L]及TC[(6.5±2.2)、(6.2 ±2.1) mmol/L]較治療前[(6.8±1.5)g/d、(2.9±1.6) mmol/L、(9.1 ±2.5) mmol/L]明顯降低,差異有統計學意義(P＜O.05或P＜O.01)；血白蛋白[(35±5)、(39±4)g/L]較治療前[(23±5) g/L]明顯升高(均P＜0.05)；治療前後Cr無明顯變化[(102±46)、(97±43)、(92±41) μmol/L,P＞O.05].觀察組治療6、12箇月各指標與對照組[尿蛋白:(4.8±3.1)、(3.6±2.1)g/d；血白蛋白:(32±5)、(38±5)/L；Cr:(99±41)、(94±38)μmol/L；TG(2.5±1.4)、(2.3±1.6) mmol/L；TC:(6.7±2.7)、(6.3±2.9) mmol/L]比較,差異無統計學意義(均P＞0.05).觀察組與對照組患者治療6及12箇月時的總有效率差異無統計學意義[65.2％(15/23)比60.9％( 14/23)、73.9％( 17/23)比69.6％( 16/23),均P＞O.05],但12箇月內不良反應髮生率[8.7％(2/23)]明顯低于對照組[34.8％ (8/23)],差異有統計學意義(P＜0.01).結論 MMF聯閤激素治療激素牴抗型IMN在達到相似臨床療效的基礎上,副作用小,患者耐受性好,值得進一步深入研究.
목적 평개마체맥고분지(MMF)연합격소치료특발성막성신병(IMN)적료효급안전성.방법 46례격소저항형IMN환자완전수궤분위관찰조(23례,MMF+발니송구복)화대조조(23례,배린선알정맥적주+발니송구복),료정12개월.관찰환자치료전、치료6급12개월뇨단백、혈백단백、Cr、TG급TC수평변화,평개치료료효급불량반응.결과 관찰조치료6급12개월후뇨단백[(4.6±2.2)、(3.3±1.5)g/d]、TG[(2.4±1.7)、(2.2±1.3) mmol/L]급TC[(6.5±2.2)、(6.2 ±2.1) mmol/L]교치료전[(6.8±1.5)g/d、(2.9±1.6) mmol/L、(9.1 ±2.5) mmol/L]명현강저,차이유통계학의의(P＜O.05혹P＜O.01)；혈백단백[(35±5)、(39±4)g/L]교치료전[(23±5) g/L]명현승고(균P＜0.05)；치료전후Cr무명현변화[(102±46)、(97±43)、(92±41) μmol/L,P＞O.05].관찰조치료6、12개월각지표여대조조[뇨단백:(4.8±3.1)、(3.6±2.1)g/d；혈백단백:(32±5)、(38±5)/L；Cr:(99±41)、(94±38)μmol/L；TG(2.5±1.4)、(2.3±1.6) mmol/L；TC:(6.7±2.7)、(6.3±2.9) mmol/L]비교,차이무통계학의의(균P＞0.05).관찰조여대조조환자치료6급12개월시적총유효솔차이무통계학의의[65.2％(15/23)비60.9％( 14/23)、73.9％( 17/23)비69.6％( 16/23),균P＞O.05],단12개월내불량반응발생솔[8.7％(2/23)]명현저우대조조[34.8％ (8/23)],차이유통계학의의(P＜0.01).결론 MMF연합격소치료격소저항형IMN재체도상사림상료효적기출상,부작용소,환자내수성호,치득진일보심입연구.
Objective To evaluate the efficacy and safety of Mycophenolate mofetile (MMF) combined with hormone in the treatment of idiopathic membranous nephropathy (IMN).Methods A total of 46 patients with hormone-resistant IMN were admitted and randomly divided into observation group (23 patients,orally administered with MMF combined with Prednisone) and control group (intravenously infused with Cyclophosphamide combined with orally administered with Prednisone) and received 6-month therapy.The changes of urine protein,blood albumin,serum creatinine,triacylglycerol and cholesterol before treatment and 6 months,12 months after treatment were observed,and the efficacy as well as adverse drug reactions (ADR) were also evaluated.Results After treated for 6 and 12 months the urine protein[ (4.6 ± 2.2) g/d,(3.3 ± 1.5) g/d],triacylglycerol [ (2.4 ± 1.7) mmol/L,(2.2 ± 1.3 ) mmol/L ] and cholesterol [ (6.5 ± 2.2) mmol/L,(6.2 ± 2.1 ) mmol/L ] of observation group were significantly decreased than those before treatment [ (6.8 ± 1.5 ) g/d,(2.9± 1.6) mmol/L,(9.1 ± 2.5 ) mmol/L ]( P ＜ 0.05 or P ＜ 0.01 ),the blood albumin [ ( 35 ± 5 ) g/L,( 39 ± 4 ) g/L] was significandy increased [ ( 23 ±5 ) g/L ] ( P ＜ 0.05 ),and no difference in serum creatinine were observed [ ( 102 ± 46) μmol/L,(97 ± 43 ) μmol/L,(92 ± 41 )μmol/L,(P ＞ 0.05 ) ].No differences in the above indexes were observed between observation group and control group [ urine albumin:(4.8 ± 3.1 ) g/d,( 3.6 ± 2.1 ) g/d; blood albumin:( 32 ± 5 ) g/L,( 38 ± 5 ) g/L; serum creatinine:(99 ±41 ) μmol/L,(94 ± 38) μmol/L; triacylglycerol (2.5 ± 1.4) mmol/L,(2.3 ±1.6) mmol/L;cholesterol:(6.7 ± 2.7) mmol/L,(6.3 ± 2.9) mmol/L ( P ＞ 0.05 ) ].There were similar efficacies between observation group and control group 6 and 12 months after treatment [ 65.2％ ( 15/23 ) vs 60.9％ ( 14/23 ),73.9％ ( 17/23 ) vs 69.6％ ( 16/23 ) ; P ＞ 0.05 ].But the incidence of ADR in observation group 8.7％ (2/23) ) was obviously lower than that in control group [ 34.8％ (8/23) ] ( P ＜ 0.01 ).Conclusion MMF combined with hormone has a good efficacy with limited side effects and good tolerance in treating hormone-resistant IMN.
