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霉酚酸酯联合布地奈德肠溶胶囊治疗高风险进展IgA肾病的临床观察
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| 篇名： | 霉酚酸酯联合布地奈德肠溶胶囊治疗高风险进展IgA肾病的临床观察 |
| TITLE： | Clinical observation of mycophenolate mofetil combined with Budesonide enteric capsules in the treatment of high-risk progressive IgA nephropathy |
| 摘要： | 目的 观察霉酚酸酯（MMF）联合布地奈德肠溶胶囊治疗高风险进展免疫球蛋白A肾病（IgAN）的临床效果。方法回顾性选取2024年8月1日至2025年3月1日于重庆大学附属三峡医院肾病学科就诊的150例成人高风险进展IgAN患者为研究对象，将使用MMF联合糖皮质激素者作为对照组（n＝94），使用MMF联合布地奈德肠溶胶囊者作为观察组（n＝56）。对比两组患者治疗后1、2、3、6个月的24h尿蛋白（24hUP）、估算肾小球滤过率（eGFR）、白蛋白（ALB）、完全缓解（CR）率及总有效率，以及治疗期间出现的不良反应。结果与治疗前比较，两组患者治疗后各时间点的24hUP均显著降低（P＜0.05）、ALB均显著升高（P＜0.05），但eGFR无显著变化（P＞0.05）。观察组患者在治疗后1、2、3个月的24hUP均显著低于对照组（P＜0.05）、ALB均显著高于对照组（P＜0.05），在治疗后6个月时上述两项指标的组间对比差异无统计学意义（P＞0.05）；两组患者治疗后各时间点的eGFR对比差异均无统计学意义（P＞0.05）。观察组患者在治疗后1、2个月时的总有效率均显著高于对照组（P＜0.05）；两组患者在其余治疗时间点的总有效率和各时间点的CR率对比差异均无统计学意义（P＞0.05）。观察组患者皮肤异常、血糖升高及总不良反应的发生率均显著低于对照组（P＜0.05）。结论相较于MMF联合糖皮质激素，MMF联合布地奈德肠溶胶囊治疗高风险进展IgAN患者，能更快速地减少蛋白尿、提升血清ALB水平，显著提高治疗早期的总有效率，降低糖皮质激素相关的皮肤不良反应、血糖升高以及总体不良反应的发生率，具有更优的短期效益。 |
| ABSTRACT： | OBJECTIVE To observe the clinical efficacy of mycophenolate mofetil （MMF） combined with Budesonide enteric capsules in the treatment of high-risk progressive immunoglobulin A nephropathy （IgAN）. METHODS A total of 150 adult patients with high-risk progressive IgAN who attended the Department of Nephrology， Chongqing University Three Gorges Hospital， between August 1， 2024 and March 1， 2025 were enrolled in this study. The control group （ n ＝94） received MMF combined with glucocorticoid， while the observation group （ n ＝56） received MMF combined with Budesonide enteric capsules. The 24-hour urine protein （24 h UP）， estimated glomerular filtration rate （eGFR）， and albumin （ALB） levels of patients in both groups were compared at 1， 2， 3， and 6 months post-treatment. The complete response （CR） rate and overall response rate were calculated for both groups at 1， 2， 3， and 6 months post-treatment. Adverse reactions occurring during treatment were compared between the two groups. RESULTS Compared with before treatment， 24 h UP decreased significantly in both groups at different time points after treatment （ P ＜0.05）， and ALB increased significantly （ P ＜0.05）. However， there was no significant change in eGFR （ P ＞0.05）. The 24 h UP in the observation group at 1， 2， and 3 months after treatment was significantly lower than that of the control group （ P ＜0.05）， while the ALB level was significan tly higher （ P ＜0.05）. However， at 6 months after treatment， there was no statistically significant difference in these two indicators between the two groups （ P ＞0.05）. There was no statistically significant difference in eGFR between the two groups at different time points after treatment （ P ＞0.05）. The overall response rates in the observation group at 1 and 2 months after treatment were significantly higher than those in the control group （ P ＜0.05）. There was no statistically significant difference in the overall response rate at the remaining treatment time points and the CR rate at all time points between the two groups （ P ＞0.05）. Patients in the observation group had significantly lower rates of skin abnormalities， elevated blood glucose， and overall adverse reactions compared with the control group （ P ＜0.05）. CONCLUSIONS Compared with MMF combined with glucocorticoids， MMF combined with Budesonide enteric capsules for the treatment of high-risk progressive IgAN patients can reduce proteinuria and improve serum ALB levels more quickly， significantly increase the early overall response rate， and significantly reduce glucocorticoid-related skin adverse reactions， blood glucose elevation， and the overall incidence of adverse reactions， demonstrating a better short-term benefits. |
| 期刊： | 2026年第37卷第07期 |
| 作者： | 沈莉；张尧；肖亚平；汤跃武；杜妮 |
| AUTHORS： | SHEN Li，ZHANG Yao，XIAO Yaping，TANG Yuewu，DU Ni |
| 关键字： | 霉酚酸酯；布地奈德肠溶胶囊；高风险进展IgA肾病；临床效果；不良反应 |
| KEYWORDS： | mycophenolate mofetil； Budesonide enteric capsules； high-risk progressive IgA nephropathy； clinical efficacy； |
| 阅读数： | 21 次 |
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