来氟米特治疗糖尿病肾病大量蛋白尿20例临床分析  

Clinical analyses of 20 cases of leflunomide on substantive proteinuria of diabetic nephropathy

作　　者：付宇[1] 王丹 石鹏[1] 赵武[1] 林为民[1] 袁莉[1] 

机构地区：[1]解放军第四五一医院肾病科 [2]解放军94162部队医院

出　　处：《临床内科杂志》2007年第7期470-471,共2页Journal of Clinical Internal Medicine

摘　　要：目的观察新型免疫抑制剂来氟米特(商品名:爱若华)治疗糖尿病肾病大量蛋白尿的疗效和安全性。方法收集临床诊断的糖尿病肾病患者20例,表现为大量蛋白尿,均为经胰岛素、血管紧张素转换酶抑制剂(ACEI)或者血管紧张素受体拮抗剂(ARB)治疗无效的患者,给予来氟米特30mg口服,1次/日,治疗2周和4周后观察24小时尿蛋白定量、血清白蛋白,同时观察甘油三酯、胆固醇、肾功能、肝功能以及不良反应。结果治疗2周后尿蛋白为(3.99±1.23)g/d,血白蛋白为(27.21±3.70)g/d,P<0.05,其中缓解4例、有效4例、无效12例,有效率为40%;治疗4周后尿蛋白为(3.22±1.43)g/d,血白蛋白为(31.14±4.54)g/d,P<0.01,其中缓解10例、有效4例,无效5例,有效率为77.8%,两组治疗2周和4周有效率比较差异具有显著性(P<0.05)。2例有明显的不良反应。结论来氟米特治疗糖尿病肾病大量蛋白尿安全、有效。Objective To observe the safety and efficacy in the therapy for substantive proteinuria of diabetic nephropathy with a new immunosupperessive drug-leflunomide （merchant name： Ai Ruo Hua）. Methods Twenty patients with clinical diagnostic diabetic nephropathy all had substantive proteinuria. The therapy were all ineffictive with insulin and angiotensin converting enzyme inhibitors（ACEI） or （ARB）. Leflunomide was used 30mg a time per day. After two and four weeks of treatment, Urine protein and plasma albumin were measured as effective indexes. At the same time, renal function, liver function, triglyceride, cholesterol and adverse reactions of the patients were oberserved. Results After 2 weeks, urine protein was 3.99 ± 1.23 ,plasma albumin was 27.21 ±3.70 （four cases relieved, four cases were effective ,twelve cases were null, and effective rate was 40%. After 4 weeks, urine protein was 3.22 ± 1.43, plasma albumin was 31.14± 4.54 （ten cases relieved, four cases were effective, five cases were null, and the effective rate was 77.8%. There were significant difference on effective rate between the beginning and the end of the therapy （ P 〈 0.05 ）. Two cases had obvious untoward reactions. Conclusion Leflunomide is safe and effective in therapy for diabetic nephropathy patients with substantive proteinuria.

关 键 词：糖尿病肾病 来氟米特 蛋白尿 

分 类 号：R587.2[医药卫生—内分泌]