THE COMPARISON OF THE EFFICACY FROM MYCOPHENOLATE MOFETIL AND CYCLOPHOSPHAMIDE IN TREATMENT OF LUPUS NEPHRITIS IV

[Objective]To Compare of mycophenolate mofetil(MMF)and intermittent cyclophosphamide(CTX)intravenous pulse therapy in treatment of diffuse proliferative(Ⅳ)lupus nephritis(LN)of clinical efficacy.[Methods]From 2002 to 2008 in Hainan Provincial People's Hospital,35 patients with lupus nephritis diagnosed by renal biopsy type Ⅳ were collected,and we compared the efficacy of the same period hormone combined MMF(MMF group,n = 16 patients)and combined CTX intermittent intravenous pulse therapy(CTX group,n = 19 patients).The MMF dose was 1.0g/d or 1.5g/d;CTX dose was 0.75-1.0g/kg·m2,and the intravenous drip was once a month.The clinical and renal biopsy of the two groups were similar.12 months of treatment were compared complete response rate and partial response rate.[Results](1)Clinical remission:the complete remission rates of 12 months after MMF treatment group and the CTX group were 43.7% and 26.3%,and partial response rates were 25.0% and 47.3%;(2)Urine Protein:MMF urinary protein in complete remission(≤ 0.4g/24h)was higher than the CTX group(43.7% vs26.3%);(3)Changes in autoantibodies:the serum anti-ds-DNA negative rate of MMF group and the CTX group of patients were 81.3% and 74.2%,respecitvely;(4)Side effects:MMF group had herpes zoster,respiratory infections,diarrhea,and leukopenia 1 case in each;CTX group had respiratory infections,2 cases had urinary tract infection,leucopenia and gastrointestinal reactions,and 1 case had elevated liver enzymes.[Conclusion]Compared with the CTX,MMF treatment of lupus nephritis Ⅳ achieved a higher complete remission rate,and rarer side effects than CTX,and good security.