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目的 回顾性分析 11例糖皮质激素治疗及 /或环磷酰胺治疗无效 ,或因严重副作用无法治疗的狼疮肾炎肾病综合征患者应用霉酚酸酯 (MMF)联合小剂量激素治疗效果。方法 病理检查证实为狼疮肾炎Ⅳ型患者 11例 ,应用糖皮质激素及环磷酰胺治疗受到限制 ,有中～重度狼疮活动依据 ,改用MMF (1 0～ 2 0 g/d)联合小剂量糖皮质激素治疗 6个月以上 [平均 (8 3± 1 5 )个月 ],同期与继续应用泼尼松及 /或环磷酰胺治疗的狼疮肾炎Ⅳ型患者 8例比较 ,观察尿蛋白、狼疮活动指数及肾功能。结果 经过MMF治疗后 ,尿蛋白由治疗前 (3 9± 0 7)g/d下降到治疗后 (1 4± 0 5 ) g/d ,狼疮活动指数明显下降 (治疗前 13 5± 3 3 ,治疗后 3 8± 1 0 ) ,其中 3例肾功能异常患者肾功能恢复正常 ,与对照组比较尿蛋白、狼疮活动指数恢复差异无显著性。结论 MMF联合应用小剂量糖皮质激素能够有效地抑制狼疮肾炎患者的狼疮活动
Objective To retrospectively analyze the effects of mycophenolate mofetil (MMF) in combination with low-dose steroid treatment in 11 patients with glucocorticoid and / or cyclophosphamide ineffective or in patients with lupus nephritis nephrotic syndrome who can not be treated with serious side effects. Methods Eleven patients with type Ⅳ of lupus nephritis were confirmed by pathological examination. The treatment with glucocorticoid and cyclophosphamide was limited. The patients with moderate to severe lupus were treated with MMF (10 ~ 20 g / d) combined with low dose of sugar Corticosteroids were treated for more than 6 months [mean (83 ± 15) months], compared with 8 cases of type IV lupus nephritis treated with prednisone and / or cyclophosphamide over the same period. Urinary protein and lupus activity Index and renal function. Results After MMF treatment, urinary protein decreased from (39 ± 0 7) g / d before treatment to (14 ± 0 5) g / d after treatment, and lupus activity index decreased significantly (before treatment, 13 5 ± 3 3, 3 8 ± 10 after treatment), of which 3 cases of renal dysfunction in patients with renal function returned to normal compared with the control group urinary protein, lupus activity index was no significant difference. Conclusion MMF combined with low-dose glucocorticoid can effectively inhibit lupus nephritis in patients with lupus activity