来氟米特治疗难治性肾病综合征疗效及安全性分析  

Analysis of the efficacy and safety of leflunomide in the treatment of refractory nephrotic syndrome

作　　者：郝娅宁[1] 尹爱萍[1] 谭峰[1] 吕晶[1] 郝大鹏[1] 

机构地区：[1]西安交通大学医学院第一附属医院肾内科,西安710061

出　　处：《临床肾脏病杂志》2006年第2期56-58,共3页Journal Of Clinical Nephrology

摘　　要：目的观察来氟米特联合糖皮质激素治疗难治性肾病综合征的疗效及安全性。方法34例难治性肾病综合征患者给予来氟米特负荷剂量50mg／d，共3d，继以30mg／d维持剂量治疗，联合泼尼松0．8～1．0mg·kg^-1·d^-1为起始剂量，6--8周开始逐渐减量或尿蛋白减半时逐渐减量，治疗第2、4、8、12和24周各随访1次，临床观察尿量、浮肿、体重、血压等，同时记录不良反应。监测血、尿常规，24h尿蛋白定量，肝功能，血脂及肾功能。结果来氟米特治疗12周完全缓解率47．1％，总有效率为75．3%（25／34），24周完全缓解率为50％，总有效率为79．2％（19／24）。治疗后12、24周尿蛋白均有明显下降（P〈0．01），血清白蛋白（ALb）显著上升（P〈0．01），肾功能无明显变化。可逆性脱发、感染为最常见副作用。结论来氟米特联合糖皮质激素可用于缓解治疗难治性肾病综合征，临床安全性和耐受性尚可，但其长期的安全性和疗效有待进一步观察。Objective To investigate the efficacy and safety of leflunomide（LEF） combined with steroid in the treatment of refractory nephrotic syndrome（RNS）. Method 34 patients with RNS treated with LEF with a loading dose of 50 mg/d for three days, followed by 30 mg/d as maintaining dose. Prednisone 0. 8-1.0 mg·kg^-1 ·d^-1 as initial dose and the dosage was gradually reduced after 6-8 weeks or when the proteinuria decreased to a half. Efficacy and safety were evaluated at 6 months after treatment. Results The complete remission rate of 12th week was 47. 1% and total effective rate was 75. 3%, the complete remission rate at 24th week was 50% and total effective rate was 79.2%, proteinuria decreased significantly（P〈0. 01 ） and serum albumin increased significantly （P〈0.01）. Reversible alopecia and infections were the most common adverse events, the others were mild and all the patients can tolerate. Conclusions LEF combined with steroid was effective in treament therapy of refractory nephrotic syndrome, The adverse effec of LEF are mild and generally well tolerated. Long-term efficacy and safety remains to be observed.

关 键 词：来氟米特 肾病综合征 难治性 疗效 安全性 

分 类 号：R692[医药卫生—泌尿科学] R135.1[医药卫生—外科学]