来氟米特治疗难治性原发性肾病综合征的临床研究  

Clinic effect of Leflunomide on refractory primary nephrotic syndrome

作　　者：陈凯[1] 李寒[2] 王世相[2] 

机构地区：[1]河南省开封市第二人民医院肾内科,河南开封475000 [2]首都医科大学附属北京朝阳医院血液净化中心,北京100020

出　　处：《中国现代医学杂志》2008年第13期1859-1862,共4页China Journal of Modern Medicine

摘　　要：目的评价来氟米特(爱若华)治疗难治性原发性肾病综合征的有效性和安全性。方法按随机表将符合入组要求的难治性原发性肾病综合征患者164例,随机分为两组,治疗组84例,给予爱若华联合中等剂量激素治疗6个月,观察其显效时间、24h尿蛋白定量、肾功能、肝功能、血常规等指标的变化及不良反应发生情况;对照组80例,给予环磷酰胺联合中等剂量激素治疗6个月,观察其显效时间、24h尿蛋白定量、肾功能、肝功能、血常规等指标的变化及不良反应发生情况。结果爱若华平均显效时间为用药后第4～8周;至第6个月总有效率为90.5%,其中完全缓解32例(38.1%),显著缓解24例(28.6%),部分缓解20例(23.8%),无效8例(9.5%);84例患者均无危及脏器及生命的严重不良反应发生;环磷酰胺平均显效时间为用药后第4～8周;至第6个月总有效率为72.5%,其中完全缓解18例(22.5%),显著缓解22例(27.5%),部分缓解18例(22.5%),无效22例(27.5%)。结论爱若华是一种治疗难治性原发性肾病综合征有效的免疫抑制剂,且耐受性良好,不良反应小,疗效优于环磷酰胺。[Objective] To investigate the clinical efficacy and safety of Leflunomide in refractory primary nephrotic syndrome. [Method] One hundred and sixty-four patients with refractory primary nephrotic syndrome （which were confirmed by renal biopsy） were involved in this trial. Eighty-four patients received Leflunomide combined with prednisone for six months. The remaining eighty patients received oral cyclophosphamide combined with prednisone for six months. The efficacy was assessed by determining the subsequent changes in blood routine, liver function and kidney function. [Results] After the treatment of Leflunomide, the patients responded within four to eight weeks averagely. At the end of the trial, the total effective rate was 90,5%, among which, thirty-two cases obtained complete clinical remission （38.1%）; twenty-four cases obtained significant clinical remission （28.6%）. After the treatment of cyclophosphamide, the patients responded within four to eight weeks averagely. At the end of the trial, the total effective rate was 72.5%; among which, eighteen cases obtained complete clinical remission （22.5%）, twenty-two cases obtained significant clinical remission （27.5%）, eighteen cases obtained partial clinical remission （22.5%） and twenty-two cases didn＇t obtain clinical remission （27.5%）. There were no severe adverse events in these patients. [Conclusion] Leflunom/de is an effective and safe immunosuppressive agent for refractory primary nephrotic syndrome.

关 键 词：肾病综合征 来氟米特 环磷酰胺 

分 类 号：R692[医药卫生—泌尿科学]