摘要
目的通过对狼疮性肾炎(LN)的临床表现、病理、肾组织病理参数评分和狼疮活动性分数的分析,比较霉酚酸酯(MMF)和环磷酰胺(CYC)治疗的效果.方法经肾活检确诊LN 35例,并将其中V型(弥漫增生型)20例分为MMF组11例采用MMF加泼尼松治疗,CYC组9例采用CYC加泼尼松治疗,随访6～8个月.结果LN 35例中肾病型20例(占57.14%)视黄醇结合蛋白(RBP)或N-乙酰-β-D氨基葡萄糖苷酶(NAG)增高.35例中血总补体(CH50)、C3、C4降低为29例(83%),而V型20例中19例降低(占95%).V型20例MMF组与CYC组比较,MMF组不良反应少,免疫学参数改善明显.结论MMF组控制V型LN活动的疗效及逆转肾脏病变的作用强于CYC组,是治疗LNV型较为有效的手段之一.
Objective To compare the curative effects in treating children with lupus nephritis （LN） by mycophenolate mofetil （MMF） and by cyclophosphamide（CYC） based on the analysis of the rating of its clinical manifestations, pathological findings and pathological parameters of kidney tissues, as well as sores of LN activity in those cases. Methods Out of the 35 LN cases confirmed by biopsy, 20 cases of type Ⅴ （disseminated proliferation type） were divided into two groups： 11 cases of MMF group treated by MMF plus prednisone,and 9 cases of CYC group which treated by CYC plus prednisone. And for both groups,six to eight months＇ follow- up were given. Results Of the 35LN cases, increased values of retinol binding protoin（RBP） or N - acetyl - beta - D- glulosarn inidase（NAG） were noted in 20 cases （renal disorder type, 57.14% ）, which suggested a compound interstitial and renal tubule damage. Also, decreased values in blood complements CH50, C3, and C4 were found in 29 cases （83 % ）, while similar findings were ,seen in 19 of the 20 type V cases （95 % ）. Compared with CYC group, MMF group with 20 cases of type Ⅴ showed fewer side effects in the treatment , but significant improvements in their immunological parameters. Conclusion The method adopted for the treatment of MMF group indicates its more powerful effects than that for CYC group in controlling activity of LN and reversing pathological changes of the kidneys, which is a more effective mearLs in the treatment of type Ⅴ LN cases.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2005年第9期895-897,共3页
Journal of Applied Clinical Pediatrics
基金
美国卫生基金项目资助(PSBH-Ⅳ-003)
作者简介
唐建华，男，副教授，学士学位，研究方向为肾脏疾病。
