来氟米特联合甲泼尼龙治疗IgA肾病的疗效观察  

Therapeutic effects of leflunomide combined with methylprednisolone in patients with IgA nephropathy

作　　者：董玉 尚顺来 李清刚[1] 陈香美[1,2] Dong Yu;Shang Shunlai;Li Qinggang;Chen Xiangmei(Department of Nephrology,Chinese PLA General Hospital,Chinese PLA Institute of Nephrology,State Key Laboratory of Kidney Diseases,National Clinical Research Center for Kidney Diseases,Beijing 100853;School of Medicine,Nankai University,Tianjin 300071,China)

机构地区：[1]解放军总医院第一医学中心肾脏病科、解放军肾脏病研究所、肾脏疾病国家重点实验室、国家慢性肾病临床医学研究中心、肾脏疾病研究北京市重点实验室,北京100853 [2]南开大学医学院,天津300071

出　　处：《中华肾病研究电子杂志》2020年第3期102-106,共5页Chinese Journal of Kidney Disease Investigation（Electronic Edition）

基　　金：国家自然科学基金(81770664);北京市自然科学基金(7202188)

摘　　要：目的评价来氟米特联合甲泼尼龙治疗IgA肾病的疗效和安全性。方法收集2008年12月至2016年10月在中国人民解放军总医院肾脏病科诊断为IgA肾病的患者75例,分别观察吗替麦考酚酯联合甲泼尼龙(MMF组,44例)与来氟米特联合甲泼尼龙(LEF组,31例)治疗IgA肾病的疗效和安全性。结果两组患者基线资料无统计学差异(P>0.05)。分别治疗2、6、10个月之后,患者24 h尿蛋白定量显著减低,血清白蛋白水平得到明显改善。但两组间的2、6、10个月后的缓解率(20.45%vs29.03%、70.45%vs77.42%、72.73%vs83.87%)和完全缓解率(9.09%vs6.45%、38.64%vs45.16%、40.91%vs48.39%)、24 h尿蛋白定量、血清白蛋白、肌酐、复发率[4例(9.09%)vs1例(3.23%)]以及不良反应[6例(13.64%)vs4例(12.9%)]无统计学差异的意义(P> 0.05)。结论来氟米特联合甲泼尼龙与吗替麦考酚酯结合甲泼尼龙疗效相当,是治疗IgA肾病的安全有效方案之一。Objective To evaluate the efficacy and safety of leflunomide combined with methylprednisolone in the treatment of IgA nephropathy.Methods 75 patients with IgA nephropathy admitted to the Department of Nephrology of the Chinese PLA General Hospital from December 2008 to October 2016 were recruited, and randomly divided into two groups: the MMF group(mycophenolate mofetil combined with methylprednisolone, 44 cases), and the LEF group(leflunomide combined with methylprednisolone,31 cases).There were no significant differences in baseline data between the two groups(P >0.05).Results After 2, 6, and 10 months of treatment, 24 h proteinuria of the patients was significantly reduced and the serum albumin level was improved, while there were no significant differences between the two groups in remission rate(20.45% vs 29.03%, 70.45% vs 77.42%, 72.73% vs 83.87%, respectively), complete remission rate(9.09% vs 6.45%, 38.64% vs 45.16%, 40.91% vs 48.39%, respectively), 24 h proteinuria, serum albumin, creatinine, recurrence rate [9.09%(4 cases) vs 3.23%(1 case)], and adverse reactions [13.64%(6 cases) vs 12.9%(4 cases)](all P > 0.05).Conclusion Leflunomide combined with methylprednisolone had the same efficacy as mycophenolate mofetil combined with methylprednisolone, and was one of the safe and effective solutions for the treatment of IgA nephropathy.

关 键 词：IGA肾病 来氟米特 疗效 

分 类 号：R692.31[医药卫生—泌尿科学]