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《Journal of Applied Clinical Pediatrics》 2009-23
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Effects of Mycophemolatemofeil on the Efficacy and Levels of Renal Type Ⅳ Collagen in Children with Henoch-Schonlein Purpura Nephritis

XU Da-liang,DONG Yang,MAO Ai-fang,GE Hong-song,ZHOU Hui-qin,ZHANG Yuan-yuan,LIN Li,WU Meng-qi,SHEN Qi(Department of Nephrology,Anhui Provincial Children's Hospital,Hefei 230051,Anhui Province,China)  
Objective To study the efficacy of mycophemolatemofeil (MMF) on Henoch-Schonlein purpura nephritis(HSPN) and investigate the effects of MMF on the levels of renal type Ⅳ collagen,and to explore the best therapy and mechanism.Methods Taking 19 children with HSPN as objectives,and the children were randomly divided into MMF group(10 cases) and control group(9 cases).The MMF group was cured by prednisone with 1 mg/(kg·d )at first,then the dosage was reduced to 0.5 mg/(kg·d) after 3 months,and finally cured by using MMF with 20 mg/(kg·d).The dosage of MMF was reduced to 0.25 g/d 3 months later.The control group was cured by using prednisone with 1.0-1.5 mg/(kg·d),then the dosage of prednisone was reduced regularly.Blood and urinary tests,hepatic and renal function,plasma-albumin,24 h protein excretion,blood and urinary β2-microglobulin(β2-MG) were performed previously,14 days and 1,3,6 months after treatments in both groups.Three children in MMF group and 4 children in control group received repeated renal biopsy.Results 1.After 3,6 months treatment,decrease of urinary protein[(0.6±0.6),(0.4±0.5) g/24 h vs (2.4±1.6) g/24 h Pa0.01)] and improvement of plasma albumin[(45±4),(45±4) g/L vs (35±7) g/L Pa0.01)] were observed in MMF group,while in control group,decrease of urinary protein was found in urinary protein[(1.2±0.8),(1.0±0.7) g/24 h vs (2.3±1.5) g/24 h Pa0.05)],but the range of decrease was less than that in MMF group,and significance was observed in control group compared with MMF group(P0.05).And improvement of plasma albumin in control group[(41±4),(43±5) g/L vs (35±6) g/L Pa0.05)],so no significance was observed in control group compared with MMF group (P0.05).2.Serum total protein were remarkably increased after 3,6 months treatment in MMF group and control group,and no significance was observed in control group compared with MMF group (P0.05).3.No significance of serum and urinary β2-MG was observed in control group compared with MMF group (Pa0.05).4.Significance was observed in the level of renal type Ⅳ collagen in control group compared with MMF group (P0.01).Conclusions MMF is more effective in reducing proteinuria than the currently widespread use of prednisone therapy in HSPN and can obviously decrease the expression of renal type Ⅳ collagen.
【Fund】: 安徽省自然科学基金项目资助(070413254X)
【CateGory Index】: R726.9
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