1.重庆大学附属三峡医院药学部,重庆 404010
2.重庆大学附属三峡医院肾病学科,重庆 404010
Received:13 November 2025,
Revised:2026-03-13,
Accepted:13 March 2026,
Published:15 April 2026
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沈莉,张尧,肖亚平,等.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 [J].中国药房,2026,37(07):927-932.
SHEN Li,ZHANG Yao,XIAO Yaping,et al.Clinical observation of mycophenolate mofetil combined with Budesonide enteric capsules in the treatment of high-risk progressive IgA nephropathy[J].ZHONGGUO YAOFANG,2026,37(07):927-932.
沈莉,张尧,肖亚平,等.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 [J].中国药房,2026,37(07):927-932. DOI: 10.6039/j.issn.1001-0408.2026.07.17.
SHEN Li,ZHANG Yao,XIAO Yaping,et al.Clinical observation of mycophenolate mofetil combined with Budesonide enteric capsules in the treatment of high-risk progressive IgA nephropathy[J].ZHONGGUO YAOFANG,2026,37(07):927-932. DOI: 10.6039/j.issn.1001-0408.2026.07.17.
目的
2
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
2
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24 h尿蛋白(24 h UP)、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
2
与治疗前比较,两组患者治疗后各时间点的24 h UP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24 h UP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
2
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。
OBJECTIVE
2
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
2
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
2
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
2
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.
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