周咏梅 林元龙 沈平 汤立 袁刚.雷公藤多苷联合吗替麦考酚酯多靶点免疫抑制治疗难治性
肾病综合症的疗效评估[J].现代生物医学进展英文版,2014,14(3):532-535. |
雷公藤多苷联合吗替麦考酚酯多靶点免疫抑制治疗难治性
肾病综合症的疗效评估 |
Effect Evaluation on Multi-Target Immunosuppressive Therapy withTripterygiumGlycosides Combined with Mycophenolate Mofetil forRefractory Nephritic Syndrome |
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DOI: |
中文关键词: 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 |
英文关键词: Refractory nephritic syndrome Multi-target immunosuppressive therapy Tripterygium glycosides Mycophenolate
mofetil |
基金项目: |
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中文摘要: |
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。 |
英文摘要: |
Objective:Toexplore clinical efficacyandsafetyonmulti-target immunosuppressive therapywithtripterygiumglycosides
combined with mycophenolate mofetil (MMF) for refractory nephritic syndrome (RNS).Methods:76 cases of RNS patients were
randomly divided into three groups. GroupA (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.Results: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. |
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