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目的观察应用霉酚酸酯(MMF)治疗乙型肝炎病毒相关性肾炎的临床疗效及安全性。方法对2000年1月至2005年1月中国医科大学附属盛京医院20例乙型肝炎病毒相关性肾炎患者给予MMF治疗,起始剂量为1.5g/d,尿蛋白降至0.5g/d时剂量减至1.0g/d维持,有乙型肝炎病毒(HBV)DNA复制的给予拉米夫定治疗。治疗前及治疗后2,3,6,9个月检测血常规、24h尿蛋白定量、血清白蛋白、肝功能、肾功能、血脂及HBVDNA定量,并记录不良反应情况。结果治疗后24h尿蛋白量明显减少(P<0.01),血清白蛋白明显上升(P<0.05),Scr明显下降(P<0.05),胆固醇及三酰甘油水平明显降低(P<0.05),未发现病毒复制增加。随访9个月完全缓解9例,总有效率85%。治疗期间未发现严重不良反应。结论MMF用于治疗乙型肝炎病毒相关性肾炎有明显疗效,且耐受性好,未见严重不良反应。
Objective To observe the clinical efficacy and safety of mycophenolate mofetil (MMF) in the treatment of hepatitis B virus associated nephritis. Methods From January 2000 to January 2005, 20 patients with hepatitis B virus associated nephritis from Shengjing Hospital affiliated to China Medical University were treated with MMF at a starting dose of 1.5g / d and urinary protein to 0.5g / d Dose was reduced to 1.0g / d maintenance, with hepatitis B virus (HBV) DNA replication to give lamivudine treatment. Before treatment and 2, 3, 6, and 9 months after treatment, the blood samples were collected and the urinary protein excretion, serum albumin, liver function, renal function, blood lipid and HBVDNA were quantified 24 hours later and the adverse reactions were recorded. Results After 24 hours of treatment, urinary protein was significantly decreased (P <0.01), serum albumin was significantly increased (P <0.05), Scr was significantly decreased (P <0.05), cholesterol and triglyceride levels were significantly decreased Virus replication was found to increase. Nine cases were followed up for 9 months and the total effective rate was 85%. No serious adverse reactions were found during treatment. Conclusion MMF is effective in treating hepatitis B virus associated nephritis with good tolerability and no serious adverse reactions.