Clinical study of prednisone and mycophenolate mofetil in treatment of IgA mesangial proliferative glomerulonephritis / 中国医师进修杂志

ABSTRACT

Objective To observe the clinical efficacy and safety of prednisone and mycophenolate mofetil in treatment of IgA mesangial proliferative glomerulonephritis.Methods Ninety-six cases of IgA mesangial proliferative glomerulonephritis were divided into control group and treatment group with 48 cases each.The patients in two groups were given conventional treatment and prednisone [prednisone usage of 0.5mg/ (kg ·d),4 weeks after the gradual reduction of weekly 5-10 mg/d].On this basis,the patients in treatment group were given mycophenolate mofetil [1.5 g/d (before 6 months) ; 1.0 g/d (6-12 months) ; 0.5g/d (12 months)].The clinical efficacy,physiological indicator and adverse reactions in two groups were observed.Results The total effective rate was 87.5％(42/48) in treatment group and 60.4％ (29/48) in control group,and there was significant difference (P ＜0.05).There was no significant difference in the physiological indicator before treatment between two groups (P ＞ 0.05).The urine volume,urine protein,albumin,blood creatinine and total cholesterol after treatment in treatment group was improved compared with that in control group [(1812 ± 355) ml/24 h vs.(1365 ± 287) ml/24 h,(2.2 ± 0.6) g/24 h vs.(3.3 ±0.6) g/24 h,(30.2 ±3.1) g/L vs.(21.9 ±4.6) g/L,(116.5 ±9.9) μmol/L vs.(143.5 ± 10.6) μmol/L,(4.7 ± 0.8) mmol/L vs.(5.8 ± 0.7) mmol/L],and there was significant difference (P ＜ 0.05).There were no serious adverse reactions in the beth groups.Conclusion Prednisone and mycophenolate mofetil can improve renal function in patients with IgA mesangial proliferative glomerulonephritis and achieve better clinical efficacy with less adverse reactions.It should be widely applied.