目的 :评估霉酚酸酯联合强的松治疗弥漫增生性狼疮肾炎的疗效及其安全性。方法 :4 6例患者随机分成 2组 ,治疗组口服霉酚酸酯加强的松 12个月 ;对照组静滴环磷酰胺加口服强的松 6个月 ,之后给予强的松和硫唑嘌呤 6个月。结果 :治疗组的 2 5个病人中的 80 %完全缓解 ,对照组中 76 %完全缓解 ,而治疗组、对照组病人部分缓解率分别为 17%和 14 %。每组各有 1个病人因副作用中断治疗 ,治疗过程中治疗组有 2 0 % ,对照组有 33%病人出现感染 (P =0 .2 9)。同时观察到仅对照组病人中出现闭经 (占病人中的 2 3% )、脱发 (19% )、白细胞减少 (10 % )及死亡(10 % )等副反应。治疗组、对照组复发率分别为 13%和 11%。结论 :对于弥漫增生性狼疮肾炎的治疗 ,霉酚酸酯和强的松联合治疗的方案与环磷酰胺和强的松治疗后序贯使用硫唑嘌呤的方案效果相同 ,而前者的副作用较少 Objective: To evaluate the efficacy and safety of mycophenolate mofetil with prednisone in the treatment of diffuse proliferative lupus nephritis. Methods: Forty-six patients were randomly divided into two groups. The treatment group was given mycophenolate mofetil for 12 months. The control group was given cyclophosphamide plus prednisone for 6 months. After that, prednisone and azathioprine 6 months. Results: 80% of the 25 patients in the treatment group were completely relieved, and 76% of the control group were completely relieved. The partial remission rates of the treatment group and the control group were 17% and 14%, respectively. One patient in each group was discontinued due to side effects, 20% of the treated group and 33% of the control group (P = .29). At the same time, side effects (23% of patients), alopecia (19%), leucopenia (10%) and death (10%) were observed in the control group. The treatment group, control group recurrence rates were 13% and 11%. CONCLUSIONS: In the treatment of diffuse proliferative lupus nephritis, the combination regimen of mycophenolate and prednisone has the same effect as the sequential regimen of azathioprine after cyclophosphamide and prednisone treatment, whereas the former has fewer side effects