来氟米特治疗难治性肾病综合征的临床观察  

Clinical observation of Treatment of Steroid-resistant or Steroid-dependent Nephrotic Syndrome with Lefiunomide

作　　者：车文体[1] 邹贵勉[1] 董力[1] 申智中[1] 陈怀周[1] 谢申平[1] 

机构地区：[1]解放军181医院肾脏科,广西桂林541002

出　　处：《华南国防医学杂志》2006年第5期3-4,17,共3页Military Medical Journal of South China

摘　　要：目的 探讨来氟米特治疗难治性肾病综合征的疗效及安全性。方法 选择激素抵抗或激素依赖的肾病综合征患者23例。患者接受来氟米特（口服负荷剂量50mg／d，连续3天，之后给予维持剂量20mg／d，疗程6个月）治疗；同时口服泼尼松（30～40mg／d，共8周，以后逐渐减量至隔日20mg维持）。观察临床疗效及副作用。结果 治疗1月后尿蛋白开始明显下降。治疗6个月后13例（56．5％）患者获得完全缓解，6例（26．1%）患者获得部分缓解，4例（17．4％）患者无效。治疗后血清白蛋白显著上升（P＜0．01）。在治疗期间5例患者出现一过性转氨酶升高，4例患者出现白细胞减少。结论 来氟米特联合泼尼松能有效地降低难治性肾病综合征患者的尿蛋白、升高血清白蛋白，且副作用较轻。Objective To explore the curative effects of Leflunomide on steroid-resistant or steroid--deperident nephrotic syndrome and its safety, Methods Twenty-three patients with steroid-resistant or steroid-dependent nephrotic syndrome were treated with Leflunomide（50mg/day loading dose for 3 days followed by 20mg/day orally for 6 months） ,and prednisone （30-40mg/ day was taken for 8 weeks ,and then the dosage of prednisone was tapered until a maintenance dosage of 20mg every other day）. The clinical curative effects and side effects were observed. Results The urine protein was significantly decreased 1 months after the treatment , Thirteen patients （56. 5 % ）achieved complete remission of the symptoms, six（ 26.1% ） partial remission, and four （ 17. 4% ） were unchanged 6 months after treatment. The level of serum albumin was elevated significantly after the treatment（ P 〈0. 01）. The transient elevation of glutamate-pyruvate transaminase was observed in five patients. Leukopenia occurred in four patients. Conelusion Leflunomide combined with prednisone is of good curative on effective patients with steroid-resistant or steroiddependent nephrotic syndrome and well tolerated by the patients.

关 键 词：来氟米特 肾病综合征 激素抵抗 激素依赖 

分 类 号：R692[医药卫生—泌尿科学]