|±¾ÆÚĿ¼/Table of Contents|

[1]ÕÅÅæ,ÖÜêÅ,ºÎÐñ,µÈ.ßäßòÁ¢±öÖÎÁƶùͯ×Ïñ°ÐÔÉöÑ×µÄÁÆЧÓ밲ȫÐÔ[J].ҽѧÑо¿ÓëÕ½´´É˾ÈÖÎ(ԭҽѧÑо¿Éúѧ±¨),2022,24(1):6-12.[doi:10.3969/j.issn.1672-271X.2022.01.002]
¡¡ZHANG Pei,ZHOU Yu,HE Xu,et al.Effect and safety of mizoribine on Henoch-Sch¢‰nlein purpura nephritis in children[J].JOURNAL OF MEDICALRESEARCH ¡ªCOMBAT TRAUMA CARE,2022,24(1):6-12.[doi:10.3969/j.issn.1672-271X.2022.01.002]
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µÚ24¾í
ÆÚÊý:
2022Äê1ÆÚ
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6-12
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2022-02-20

ÎÄÕÂÐÅÏ¢/Info

Title:
Effect and safety of mizoribine on Henoch-Sch¢‰nlein purpura nephritis in children
×÷Õß:
ÕÅÅæÖÜêźÎÐñʷ׿ËïÌÎÑîÏþ¿ïǪ»ÜÄûÒ¦¿¡·½Ïã¸ßÔ¶¸³¸ß´ºÁÖÏÄÕýÀ¤
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Author(s):
ZHANG Pei ZHOU Yu HE Xu SHI Zhuo SUN TaoYANG Xiao KUANG Qian-hui-ning YAO Jun FANG Xiang GAO Yuan-fu GAO Chun-lin XIA Zheng-kun
£¨Department of Paediatrics, The Second School of Clinical Medicine, Southeast University/General Hospital of Eastern Theater Command, PLA, Nanjing 210002, Jiangsu, China£©
¹Ø¼ü´Ê:
ßäßòÁ¢±ö×Ïñ°ÐÔÉöÑ׶ùͯÁÆЧ
Keywords:
mizoribine Henoch-Sch¢‰nlein purpura nephritis children clinical effect
·ÖÀàºÅ:
R726.9
DOI:
10.3969/j.issn.1672-271X.2022.01.002
ÎÄÏ×±êÖ¾Âë:
A
ÕªÒª:
Ä¿µÄ̽ÌÖßäßòÁ¢±ö£¨MZR£©ÖÎÁƶùͯ×Ïñ°ÐÔÉöÑ×£¨HSPN£©µÄÁÆЧÓ밲ȫÐÔ¡£·½·¨Ñ¡Ôñ2016Äê1ÔÂÖÁ2017Äê10Ô¶«²¿Õ½Çø×ÜÒ½Ôº¶ù¿ÆÊÕÖεĶùͯHSPN55Àý£¬°´ÕÕËæ»úÊý×Ö·Ö×é·¨Ëæ»ú·ÖΪ2×飺ǿµÄËÉ£¨PDN£©ÓëMZRÁªºÏÖÎÁÆ×飨ÁªºÏ×飬n=38£©ºÍMZRµ¥Ò©ÖÎÁÆ×飨µ¥Ò©×飬n=17£©¡£·ÖÎö2×黼¶ùµÄËæ·Ã3¸öÔ¡¢6¸öÔ¡¢12¸öÔºÍ24¸öÔÂʵÑéÊÒ¼ì²é½á¹û¡¢Ô¤ºóºÍ²»Á¼·´Ó¦¡£½á¹ûÁªºÏ×é6¸öÔ¡¢12¸öÔºÍ24¸öÔÂALBˮƽ¸ßÓÚ»ùÏßÖµ£¨P<0.05£©£»µ¥Ò©×é12¸öÔºÍ24¸öÔÂALBˮƽ¸ßÓÚ»ùÏßÖµ£¨P<0.05£©£»ÁªºÏ×é6¸öÔ¡¢12¸öÔºÍ24¸öÔÂÄòµ°°×¶¨Á¿Ë®Æ½µÍÓÚ»ùÏßÖµ£¨P<0.05£¬P<0.01£©£»µ¥Ò©×é12¸öÔºÍ24¸öÔÂÄòµ°°×¶¨Á¿Ë®Æ½µÍÓÚ»ùÏßÖµ£¨P<0.05£¬P<0.01£©£»ÁªºÏ×é3¸öÔ¡¢6¸öÔ¡¢12¸öÔºÍ24¸öÔÂÄòNAGøˮƽµÍÓÚ»ùÏßÖµ£¨P<0.01£©£»µ¥Ò©×é6¸öÔ¡¢12¸öÔºÍ24¸öÔÂÄòNAGøˮƽµÍÓÚ»ùÏßÖµ£¨P<0.05£¬P<0.01£©£»ÁªºÏ×é6¸öÔ¡¢12¸öÔºÍ24¸öÔÂÄòRBµ°°×ˮƽµÍÓÚ»ùÏßÖµ£¨P<0.05£¬P<0.01£©£»µ¥Ò©×é12¸öÔºÍ24¸öÔÂÄòRBµ°°×ˮƽµÍÓÚ»ùÏßÖµ£¨P<0.01£©¡£Ô¤ºó·Ö¼¶£ºA¼¶ºÍ×ÜÌåÔ¤ºó·Ö¼¶ÁªºÏ×é¸ßÓÚµ¥Ò©×飨97.37% vs 82.35%,P<0.05£©£¬B¼¶Ô¤ºó·Ö¼¶ÁªºÏ×éµÍÓÚµ¥Ò©×飨2.63% vs 17.65%,P<0.05£©¡£ÁªºÏ×éÄòµ°°×Ïûʧ±ÈÀýÃ÷ÏÔ¸ßÓÚµ¥Ò©×飨P<0.01£©¡£ÁªºÏ×éѪWBCÉý¸ß±ÈÀý¸ßÓÚµ¥Ò©×飨86.84% vs 58.82%,P<0.05£©£¬ºôÎüµÀ¸ÐȾ´ÎÊý¸ßÓÚµ¥Ò©×飨63.16% vs 23.53%,P<0.05£©£¬HSP¸´·¢´ÎÊýµÍÓÚµ¥Ò©×飨2.63% vs 17.65%,P<0.05£©¡£½áÂÛMZRÖÎÁƶùͯHSPNÓÐЧÐԺͰ²È«ÐԽϸߣ¬PDNÁªºÏMZRÖÎÁÆHSPNµÄÁÙ´²Ð§¹û¸ßÓÚµ¥Ò©MZR£¬ÇÒ³¤ÆÚÔ¤ºóºÃÓÚµ¥Ò©MZR¡£
Abstract:
ObjectiveTo investigate the efficacy and safety of mizoribine (MZR) in children with Henoch-Sch¢‰nlein purpura nephritis (HSPN).MethodsFrom January 2016 to October 2017, 55 cases of children with HSPN admitted to the Department of Paediatrics of Jinling Hospital were analyzed. According to the treatment, all patients were divided into prednisone (PDN) and MZR combined treatment groups (PDN+MZR group, n=38) and MZR monotherapy group (MZR group, n=17). The laboratory test results of 3 mouths, 6 mouths, 12 mouths and 24 mouths follow-up time, prognosis and adverse reactions of the two groups of children were analyzed.ResultsAt the follow-up time of 6 mouths, 12 mouths and 24 mouths, the albumin (ALB) levels in PDN+MZR group were higher than the baseline (P<0.05). At 12 mouths and 24 mouths time, the ALB levels in MZR group were higher than the baseline (P<0.05). At 6 mouths, 12 mouths and 24 mouths time, urine protein level in PDN+MZR group were lower than the baseline (P<0.05, P<0.01). At 12 mouths and 24 mouths time, urine protein level in MZR group were lower than the baseline (P<0.05, P<0.01). At 3 mouths, 6 mouths, 12 mouths and 24 mouths time, the urinary NAG enzyme level in PDN+MZR group were lower than the baseline (P<0.01). At 6 mouths, 12 mouths and 24 mouths time, the urinary NAG enzyme level in MZR group were lower than the baseline (P<0.05, P<0.01). At 6 mouths, 12 mouths and 24 mouths time, the urinary RB protein levels in PDN+MZR group were lower than the baseline (P<0.05, P<0.01). At 12 mouths and 24 mouths time, the urine RB protein level in the MZR group was lower than the baseline (P<0.01). A prognosis classification and overall prognosis classification in PDN+MZR group was higher than that in MZR group (97.37% vs 82.35%, P<0.05). B prognosis classification in PDN+MZR group was lower than that in MZR group (2.63% vs 17.65%, P<0.05). The percentage of urinary protein disappearance in PDN+MZR group was higher than that in MZR group (P<0.01). The proportion of increased blood WBC in the PDN+MZR group was higher than that in MZR group (86.84% vs 58.82%, P<0.05). The number of respiratory infections in the PDN+MZR group was higher than that in MZR group (63.16% vs 23.53%, P<0.05). And the number of HSP recurrences in the PDN+MZR group was lower than that in MZR group (2.63% vs 17.65%, P<0.05).ConclusionMZR is shown an effectiveness and safety in the treatment of children with HSPN. The clinical effect of PDN combined with MZR in the treatment of HSPN is higher than MZR monotherapy. And the long-term prognosis is better than MZR monotherapy.

²Î¿¼ÎÄÏ×/References:

[1]Ozen S, Acar-Ozen NP. Recent advances in childhoodvasculitis[J]. Curr Opin Rheumatol£¬2017£¬29(5): 530-534.
[2]Buscatti IM, Casella BB, Aikawa NE£¬et al. Henoch-Sch¢‰nlein purpura nephritis: initial risk factors and outcomes in a Latin American tertiary center[J]. Clin Rheumatol£¬2018£¬37(5): 1319-1324.
[3]Yel S, Dursun I, Pinarba ÿðþ ‰D i AS£¬et al. Patient Outcomes of Henoch-Sch¢‰nlein Purpura Nephritis According to the New Semiquantitative Classification[J]. Fetal Pediatr Pathol£¬2020£¬39(5): 381-389.
[4]Sugimoto H, Matsuno S, Yamanaka N£¬et al. Low-dose corticosteroid with mizoribine might be an effective therapy for elderly-onset ISKDC grade VI IgA vasculitis[J]. CEN Case Rep£¬2020£¬10(1):46-52.
[5]Sugimoto H, Matsuno S, Yamanaka N£¬et al. Low-dose corticosteroid with mizoribine might be an effective therapy for elderly-onset ISKDC grade VI IgA vasculitis[J]. CEN Case Rep£¬2021£¬10£¨1£©£º46-52.
[6]Kagawa H, Hiromasa T, Yamanaka R£¬et al. The first year results of mizoribine tacrolimus-based multitarget treatment for consecutive patients with lupus nephritis[J]. Clin Exp Nephrol£¬2018£¬22(6)£º1371-1378.
[7]Ikeda K, Watanabe K, Hirai T£¬et al. Mizoribine Synchronized Methotrexate Therapy should be Considered when Treating Rheumatoid Arthritis Patients with an Inadequate Response to Various Combination Therapies[J]. Intern Med£¬2017£¬56£¨10£©£º1147-1152.
[8]Izumi Y, Nakaoka K, Kamata M£¬et al. Steroid-resistant protein-losing gastroenteropathy complicated with Sj¢‰gren¡¯s syndrome successfully treated with mizoribine[J]. Mod Rheumatol£¬2018£¬28(4): 716-720.
[9]Liu L, Ren B, Zhang H£¬et al. Population Pharmacokinetic Analysis of Mizoribine in Chinese Renal Transplant Recipients[J]. Transplant Proc£¬2018£¬50(8): 2392-2397.
[10]ÖлªÒ½Ñ§»á¶ù¿Æѧ·Ö»áÉöÔàѧ×é. ×Ïñ°ÐÔÉöÑ×ÕïÖÎÑ­Ö¤Ö¸ÄÏ(2016) [J]. Öлª¶ù¿ÆÔÓÖ¾£¬2017£¬55£¨9£©£º647-651.
[11]Feng D, Huang WY, Hao S£¬et al. A single-center analysis of Henoch-Schonlein purpura nephritis with nephrotic proteinuria in children[J]. Pediatr Rheumatol Online J£¬2017£¬15(1)£º15.
[12]Xia ZK, Gao YF, Rong LP£¬et al. Usefulness of mizoribine administration in children with frequently relapsing nephrotic syndrome, and the relationship between pharmacokinetic parameters and efficacy: a multicenter prospective cohort study in China[J]. World J Pediatr£¬2019£¬15(3)£º262-269.
[13]KDIGO. Chapter 11: Henoch-Schonlein purpura nephritis[J]. Kidney International Supplements£¬2012£¬2(2): 218-220.
[14]Mima A. Efficacy of mizoribine and prednisolone combination therapy in adult patients with IgA vasculitis[J]. Rheumatol Int£¬2017£¬37(8): 1387-1393.
[15]Ikeda K, Watanabe K, Hirai T£¬et al. Mizoribine Synchronized Methotrexate Therapy should be Considered when Treating Rheumatoid Arthritis Patients with an Inadequate Response to Various Combination Therapies[J]. Intern Med£¬2017£¬56(10)£º1147-1152.
[16]Natale P, Palmer SC, Ruospo M£¬et al. Immunosuppressive agents for treating IgA nephropathy[J]. Cochrane Database Syst Rev£¬2020£¬3(3)£ºCD003965. doi: 10.1002/14651858.CD003965.pub3.
[17]Kurokawa Y, Koike K, Kaida Y£¬et al. Effectiveness of cryofiltration and mizoribine combination with oral steroid therapy in a patient with membranoproliferative glomerulonephritis due to essential cryoglobulinemia[J]. CEN Case Rep£¬2019£¬8(3): 205-211.
[18]Kondoh T, Ikezumi Y, Yokoi K£¬et al. Assessment of factors associated with mizoribine responsiveness in children with steroid-dependent nephrotic syndrome[J]. Clin Exp Nephrol£¬2019£¬23(9)£º1154-1160.
[19]Lee D, Kim HY, Lee JH£¬et al. Long-term Survival Analysis of Kidney Transplant Recipients Receiving Mizoribine as a Maintenance Immunosuppressant: A Single-Center Study[J]. Transplant Proc£¬ 2019£¬51£¨8£©£º2637-2642.
[20]Huang Y, Han M, Yang D£¬et al. Comparative Study of Mizoribine and Mycophenolate Mofetil Combined with a Calcineurin Inhibitor-Based Immunosuppressive Regimen in Patients with Alternative Donor Hematopoietic Cell Transplantation[J]. Biol Blood Marrow Transplant£¬2020£¬26(9): 1663-1669.
[21]Mizutani A, Fujinaga S, Sakuraya K£¬et al. Positive effects of single-daily high-dose mizoribine therapy after cyclophosphamide in young children with steroid-dependent nephrotic syndrome[J]. Clin Exp Nephrol£¬2019£¬23(2)£º244-250.
[22]Hama T, Nakanishi K, Ishikura K£¬et al. Study protocol: high-dose mizoribine with prednisolone therapy in short-term relapsing steroid-sensitive nephrotic syndrome to prevent frequent relapse (JSKDC05 trial) [J]. BMC Nephrol£¬2018£¬19(1): 223.
[23]Ren P, Han F, Chen L£¬et al. The combination of mycophenolate mofetil with corticosteroids induces remission of Henoch-Sch¢‰nlein purpura nephritis[J]. Am J Nephrol£¬2012£¬36(3)£º271-277.
[24]Í¿¾ê£¬³Â³¯Ó¢. ÒÔÇá¶Èµ°°×ÄòΪÖ÷Òª±íÏֵĶùͯ×Ïñ°ÐÔÉöÑ×ÁÙ´²·ÖÎö[J]. ÖлªÊµÓöù¿ÆÁÙ´²ÔÓÖ¾£¬2017£¬32(17): 1313-1315.
[25]Sakurai K, Kubo K, Kanda H£¬et al. Efficacy of combination therapy with tacrolimus and mizoribine for cyclophosphamide-resistant ANCA-associated glomerulonephritis[J]. Int J Rheum Dis£¬2017£¬20£¨12£©£º2214-2216.
[26]Ikeda Y, Fukunari K, Uchiumi S£¬et al. A case of anti-neutrophil cytoplasmic antibody-associated vasculitis with anti-glomerular basement membrane antibodies that was successfully treated with mizoribine as a safe and effective remission maintenance therapy with prednisolone and plasma exchange[J]. CEN Case Rep£¬2020£¬9(1): 42-47.
[27]Chen P, Xu X, Liu L£¬et al. Prediction of mizoribine pharmacokinetic parameters by serum creatinine in renal transplant recipients[J]. Eur J Clin Pharmacol£¬2019£¬75(3):363-369.
[28]Shi Y, Liu H, Chen XG£¬et al. Hyperuricemia in Living Donor Kidney Transplantation Patients During Mizoribine Administration Caused Mainly by Changes in Kidney Function[J]. Transplant Proc£¬2019£¬51(5): 1392-1396.
[29]Li SF, Gong MJ, Sun YF£¬et al. In Vitro and in Vivo Antiviral Activity of Mizoribine Against Foot-And-Mouth Disease Virus[J]. Molecules£¬2019£¬24£¨9£©£º1723. doi: 10.3390/molecules24091723.
[30]ѦԴ£¬ÕÔÓîÀÙ£¬ÆëлÃô£¬µÈ. ÓÐÏÞ²ÉÑù·¨¹ÀËãÉö²¡»¼¶ù¿Ú·þßäßòÁ¢±öҩʱÇúÏßÏÂÃæ»ýÄ£Ð͵Ľ¨Á¢ÓëÑéÖ¤[J]. ҽѧÑо¿Éúѧ±¨£¬2020,33(9£©£º968-973.

ÏàËÆÎÄÏ×/References:

[1]ÕÅÅæ,ÖÜêÅ,¸ß´ºÁÖ,µÈ.ßäßòÁ¢±öÁªºÏÌÇƤÖʼ¤ËØÖÎÁƶùͯIgAÉö²¡µÄÁÙ´²Ñо¿[J].ҽѧÑо¿ÓëÕ½´´É˾ÈÖÎ(ԭҽѧÑо¿Éúѧ±¨),2022,24(4):356.[doi:10.3969/j.issn.1672-271X.2022.04.005]
¡¡ZHANG Pei,ZHOU Yu,GAO Chun-lin,et al.Clinical research of mizoribine in the treatment of children with IgA nephropathy[J].JOURNAL OF MEDICALRESEARCH ¡ªCOMBAT TRAUMA CARE,2022,24(1):356.[doi:10.3969/j.issn.1672-271X.2022.04.005]

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