来氟米特治疗特发性膜性肾病对尿C5b-9和Podocalyxin含量的影响  

作　　者：何雪晴[1] 冯曦[1] 龚苏飞[1] 

机构地区：[1]南京医科大学附属常州市第二人民医院肾内科,213003

出　　处：《当代医学》2011年第34期22-24,共3页Contemporary Medicine

摘　　要：目的观察来氟米特治疗特发性膜性肾病的临床疗效和安全性,以及对尿C5b-9和Podocalyxin含量的影响。方法将特发性膜性肾病患者20例随机分为来氟米特治疗组(LEF组,n=10)和卡托普利对照组(CAP组,n=10),分别给予来氟米特和卡托普利治疗12月,观察各组的疗效、不良反应以及对尿C5b-9和Podocalyxin含量的影响。结果 LEF组缓解率为70%(3例完全缓解,4例部分缓解);CAP组缓解率20%(均为部分缓解)。LEF组从治疗第3个月起尿蛋白显著降低,血清白蛋白显著升高;CAP组至治疗12个月尿蛋白显著低于治疗前,血清白蛋白无明显改变;治疗第3个月起LEF组尿蛋白显著低于CAP组,血清白蛋白显著高于CAP组。尿C5b-9、PCX含量LEF组治疗后显著降低,而CAP组治疗前后无变化。结论 LEF治疗特发性膜性肾病有较高的临床缓解率,且能抑制C5b-9产生,减少足细胞损伤。Objective To study the efficacy and safety of leflunomide（LEF） and the effect of leflunomide on C5b-9 and Podocalyxin urinary excretioff in the treatment of idiopathic membranous nephropathy （IMN）. Methods This study included a group of 20 IMN patients, among them 10 were treated with lefiunomide and 10 with captopril（CAP）. In the LEF group, the initial dosage of LEF was 0.8mg/（Kgod）, 3 days later, 30mg/d, for one week, and then maintained at 20mg/d for 12 months. In the CAP group, CAP was given at a dosage of 37.5mg/d. Follow up interviews were regularly conducted. Results At the end of this study, 3（3/10） complete remissions（CR） and 4（4/10） partial remissions（PR） were observed in the LEF group while only 2（2/10） PRs were observed in the CAP group. From the end of the 3rd month, the patients in the LEF group had lower 24-hour urinary protein excretion and higer serum albumin than the patiens in the CAP group. C5b-9 and Podocalyxin urinary excretion of the patiens in the LEF group were decreased at the end of the study, while no difference was＂ found in the CAP group. Conclusion LEF is an effective and safe agent for IMN possibily through down-regulation C5b-9 and profective effect on the podocyte.

关 键 词：特发性膜性肾病 来氟米特 膜攻击复合物 PODOCALYXIN 

分 类 号：R692.3[医药卫生—泌尿科学]