Wang Xichao, Song Xinyuan, Liu Ying, Zhang Wenyu, An Wenwen, Tu Yangke
Department of Nephrology, Tianjin First Center Hospital, Tianjin 300192, China.
Department of Nephrology, Tianjin First Center Hospital, Tianjin 300192, China.
Life Sci. 2016 Jun 1;154:75-8. doi: 10.1016/j.lfs.2016.04.012. Epub 2016 Apr 11.
Membranous nephropathy remains the most common form of the nephrotic syndrome in adults. The combination therapy of steroid and cyclophosphamide has routinely been used. Although satisfactory therapeutic efficacy can be achieved, its side effect on reproductive system has been a concern. Mizoribine is an imidazole nucleoside and a novel immunosuppressant that has been used to treat other immune-related diseases. In this study we examine if the combined regimen of mizoribine and steroid would be advantageous over the use of cyclophosphamide and steroid in treating adult membranous nephropathy.
There were total of fifty-five patients completed the study. These patients had membranous nephropathy with presentation of proteinuria. They were treated with combined regimen of mizoribine and steroid or cyclophosphamide and steroid, and were followed up for one year to monitor safety and efficacy.
We found the condition of proteinuria was significantly improved in the mizoribine group and the improvement was comparable to the patients treated with cyclophosphamide. These patients also exhibited an increase of serum albumin. There was no significant increase of adverse events with the use of mizoribine-based therapy, suggesting the tolerability of mizoribine in adult patients with membranous nephropathy.
In conclusion, the results indicated the satisfactory safety and efficacy of the combination regiment of mizoribine and steroid in treating adult patients with membranous nephropathy.
膜性肾病仍是成人肾病综合征最常见的形式。类固醇与环磷酰胺的联合疗法一直被常规使用。尽管能取得令人满意的治疗效果，但其对生殖系统的副作用一直令人担忧。咪唑立宾是一种咪唑核苷，也是一种新型免疫抑制剂，已被用于治疗其他免疫相关疾病。在本研究中，我们探究咪唑立宾与类固醇的联合方案在治疗成人膜性肾病方面是否比环磷酰胺与类固醇的联合方案更具优势。
共有55名患者完成了本研究。这些患者患有膜性肾病并伴有蛋白尿。他们接受了咪唑立宾与类固醇或环磷酰胺与类固醇的联合方案治疗，并随访一年以监测安全性和疗效。
我们发现咪唑立宾组的蛋白尿状况显著改善，且改善程度与接受环磷酰胺治疗的患者相当。这些患者的血清白蛋白也有所增加。使用基于咪唑立宾的治疗方案时不良事件没有显著增加，这表明咪唑立宾对成年膜性肾病患者具有耐受性。
总之，结果表明咪唑立宾与类固醇的联合方案在治疗成年膜性肾病患者方面具有令人满意的安全性和疗效。
