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目的 :研究霉酚酸酯 (MMF)对狼疮性肾炎 (LN)肾脏慢性化病变的影响。 方法 :9例LN患者采用MMF联合中小剂量激素疗法。免疫组化法检测治疗前后肾内α 平滑肌肌动蛋白 (α SMA)和转化生长因子 β1(TGF β1)的表达。 结果 :MMF治疗 6个月后 ,LN患者的蛋白尿、自身抗体等临床指标均获得明显改善 ,肾组织慢性化指数治疗前后改变无统计学差异 (P >0 0 5 )。患者肾小球内α SMA的表达明显减少 (P <0 0 5 ) ,而肾小管间质中α SMA和肾内TGF β1的表达治疗后有部分下降但无统计学意义。肾间质血管上α SMA的表达治疗前后无明显差异。结论 :MMF治疗 6个月后 ,患者肾内α SMA和TGF β1的表达部分下降 ,可能是肾脏慢性化病变无明显进展的重要原因之一。
Objective: To investigate the effect of mycophenolate mofetil (MMF) on chronic kidney disease in patients with lupus nephritis (LN). Methods: Nine patients with LN were treated with MMF combined with small and medium dose hormone therapy. Immunohistochemistry was used to detect the expression of α SMA and TGF β1 in the kidney before and after treatment. Results: After 6 months MMF treatment, the clinical indicators such as proteinuria and autoantibodies in patients with LN were significantly improved. There was no significant difference between before and after treatment of chronic renal failure (P> 0.05). The expression of α SMA in glomerulus was significantly decreased (P <0.05), while the expression of α SMA and TGF β1 in renal tubulointerstitial tissue was partly decreased but not statistically significant. There was no significant difference in the expression of α SMA on the renal interstitium before and after treatment. CONCLUSIONS: After 6 months of MMF treatment, the expression of α SMA and TGF β1 in the kidney may be partially decreased, which may be one of the important reasons for no significant progression of chronic kidney disease.