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目的比较霉酚酸酯(MMF)与间断环磷酰胺静脉冲击疗法(CYC)治疗弥漫增生型狼疮性肾炎的临床效果及不良反应的发生率。方法 120例弥漫增生型狼疮性肾炎的患者随机分为MMF组和CYC组,每组60例。MMF组采用霉酚酸酯配合激素治疗,CYC组采用间断环磷酰胺静脉冲击疗法配合激素治疗。比较两组患者治疗1年后实验室指标的变化、临床效果及不良反应的发生率。结果 MMF组临床指标的变化明显优于CYC组,MMF组(总有效率98.33%)临床治疗效果明显好于CYC组(总有效率70.00%),MMF组不良反应的发生率明显低于CYC组,差异均具有统计学意义(P<0.05)。结论霉酚酸酯能显著改善弥漫增生型狼疮性肾炎患者的临床指标,提高疗效,降低不良反应的发生率,总体治疗效果明显优于间断环磷酰胺静脉冲击疗法,建议推广。
Objective To compare the clinical efficacy and adverse reactions of mycophenolate mofetil (MMF) and intermittent cyclophosphamide (PBX) in the treatment of diffuse proliferative lupus nephritis. Methods A total of 120 patients with diffuse proliferative lupus nephritis were randomly divided into MMF group and CYC group, 60 cases in each group. MMF group with mycophenolate mofetil therapy, CYC group with intermittent cyclophosphamide venous pulse therapy with hormone therapy. The changes of laboratory indexes, clinical effects and the incidence of adverse reactions after one year of treatment in both groups were compared. Results The changes of clinical indexes in MMF group were significantly better than those in CYC group. The clinical effect of MMF group (total effective rate 98.33%) was significantly better than that of CYC group (total effective rate 70.00%). The incidence of adverse reactions in MMF group was significantly lower than that in CYC group , The differences were statistically significant (P <0.05). Conclusion Mycophenolate mofetil can significantly improve the clinical indexes of patients with diffuse proliferative lupus nephritis, improve the curative effect and reduce the incidence of adverse reactions. The overall curative effect is better than that of intermittent cyclophosphamide intravenous pulse therapy.