摘要
目的:探讨雷公藤多苷联合吗替麦考酚酯(MMF)多靶点免疫抑制治疗难治性肾病综合症(RNS)的临床疗效及安全性。方法:将76例RNS患者随机分为三组,A组(30例)采用雷公藤多苷联合MMF多靶点免疫抑制疗法,B组(29例)采用环磷酰胺(CTX)冲击疗法,C组(27例)采用MMF疗法,总疗程均为6个月。比较分析三组的临床疗效、肾功能、复发情况及不良反应。结果:A组的总有效率为73.3%,显著高于B组48.3%,C组44.4%(P<0.05);治疗后,三组的肾功能指标均有所改善,与B组和C组比较,A组尿蛋白定量、血肌酐(Scr)显著降低,血清白蛋白(ALB)显著升高(P<0.05);A组的复发率(0%)显著低于B组(21.4%)和C组(15.4%)(P<0.05)。A组不良反应发生率与B组、C组之间的差异无统计学意义(P>0.05)。结论:雷公藤多苷联合MMF多靶点治疗RNS安全有效,可减少免疫抑制剂的剂量,提高缓解率,改善肾功能,且不良反应少。
Objective： To explore clinical efficacy and safety on multi-target immunosuppressive therapy with tripterygium glycosides combined with mycophenolate mofetil （MMF） for refractory nephritic syndrome （RNS）. Methods： 76 cases of RNS patients were randomly divided into three groups. Group A （N=30） was given multi-target immunosuppressive therapy with tripterygium glycosides combined with MMF, Group B （N=29） was given cyclophosphamide （CTX） pulse therapy, and Group C （N=27） was given MMF, respectively. The clinical effect, renal function, recurrence rate and side effect were observed. Result： The clinical effect in Group A was 73.3%, was significantly higher than that in Group B 48.3% and Group C 44.4% （P〈0.05）. The renal function in all groups was improved after treatment, while the levels of 24 h proteinuria, Scr were lower and ALB was higher significantly in Group A compared with those in Group B and Group C （P〈0.05）. The recurrence rate in Group A （0%） was significantly lower than that in Group B 21.4 % and Group C 15.4 %. There was no significant difference on the side effect among the three groups （P〉0.05）. Conclusion： It is effective and safe of multi-target immunosuppressive therapy with tripterygium glycosides and MMF for RNS, it can contribute to reduce the dosage of immunosuppressant, improve remission rate and renal function, and has a relative lower side effects.
出处
《现代生物医学进展》
CAS
2014年第3期532-535,共4页
Progress in Modern Biomedicine
关键词
难治性肾病综合症
多靶点免疫抑制
雷公藤多苷
吗替麦考酚酯
Refractory nephritic syndrome
Multi-target immunosuppressive therapy
Tripterygium glycosides
Mycophenolate mofetil
