Objective To assess the effectiveness and safety of mycophenolate mofetil (MMF) in the treatment of proliferative lupus nephritis. Methods We searched CBM (November 1979 to February 2006), Chinese Cochrane Centre Database (2005), The Cochrane Library (Issue 4, 2005), MEDLINE (November 1966 to February 2006) and EMBASE (1975 to February 2006) for randomize controlled trials. Data were extracted and analyzed using The Cochrane Collaboration’s RevMan 4.2.7. Results Nine randomize controlled trials involving 512 patients met the inclusion criteria. The meta-analysis showed that the total clinical effective rate and complete remission rate were not significantly higher for MMF than for cyclophosphamide, azathioprine, or both. Renal survival rate and relapse rate of MMF were not significantly different from those for cyclophosphamide, azathioprine, or both. Patient survival rate and safety of MMF were significantly improved compared with cyclophosphamide, azathioprine, or both. Conclusion More large-scale multi-center randomized trials are needed to investigate the role of MMF in the treatment of proliferative lupus nephritis.
【摘要】 目的 分析乳酸性酸中毒發生的危險因素，警示臨床工作。 方法 回顧性分析2008年5月—2010年12月收治的32例乳酸性酸中毒患者的臨床資料。 結果 32例患者均合并2型糖尿病，其中老年患者27例（占84.6%）；20例有服用雙胍類降糖藥物史（占62.5%）；12例合并肺部疾病（占37.5%）；9例合并心臟疾病（占28.1%）；15例合并腎功能不全（占46.9%）；8例合并肝功能異常（占25.0%）。 結論 糖尿病、老年、使用雙胍類藥物、合并心肺疾病及肝腎功能不全都是發生乳酸性酸中毒的危險因素。在臨床工作中，對高危患者需提高警惕，盡量避免危險因素疊加以減少乳酸性酸中毒的發生。【Abstract】 Objective To analyze the risk factors of lactic acidosis. Methods The clinical data of 32 patients with lactic acidosis admitted to our hospital from May 2008 to December 2010 were studied retrospectively. Results All patients had type 2 diabetes mellitus. Among them, 27 (84.6%) were older than 60, 20 (62.5%) had ingested antidiabetic drugs of biguanides, 12 (37.5%) were complicated by pulmonary diseases, 9 (28.1%) by heart diseases, 15 (46.9%) by renal dysfunction, and 8 (25.0%) by liver dysfunction. Conclusions Diabetes mellitus, old age, ingesting of biguanides, cardiopulmonary diseases, renal and hepatic dysfunction all contribute to the occurrence of lactic acidosis. During clinical work, we should try to avoid the above-mentioned risk factors.