来氟米特联合糖皮质激素治疗IgA肾病的研究  

Effect of urinary transforming growth factor-β1 （TGFβ1） on Leflunomide in combination with prednisolone in treatment of IgA nephropathy

作　　者：常靖[1] 宋修芹 张文娟[1] 邱晓军[1] 方展[1] 

机构地区：[1]山东省烟台市烟台山医院,264001

出　　处：《中国误诊学杂志》2012年第12期2818-2820,共3页Chinese Journal of Misdiagnostics

摘　　要：目的观察来氟米特（leflunomide，LEF）与激素治疗IgA肾病患者的疗效及其对尿转化生长因子B1（TGFβ1）的影响。方法选取符合条件的60例IgA肾病患者。将其分为LEF组和激素组各30例．LEF组给予口服LEF联合泼尼松治疗，激素组予口服泼尼松治疗。采用酶联免疫吸附试验（ELISA）检测尿TGF{31，检测值均用尿肌酐（Cr）进行校正。用药期间检测尿TGFβ1／Cr的排泄水平、Z4h尿蛋白定量、血清白蛋白、血常规、肝肾功能等指标，进行统计学分析。结果LEF组治疗后尿TGFβ1／Cr水平、24h尿蛋白定量均显著下降（P〈0．01），总有效率为85．7％。两组治疗后尿TGFIβ1／Cr水平差异有统计学意义（P〈0．05）。与激素组比较疗效存在显著差异（P〈0．01），不良反应轻微。结论LEF联合中小剂量激素治疗IgA肾病比单纯应用激素的临床疗效好，抑制TGFβ1的表达可能是其治疗机制之一。Objective To observe the effect of leflunomide（LEF） in combination with medium/low dose prednisolone in treatment of IgA nephropathy and its influence on the level of urinary transforming growth factor-β1 （TGFβ1 ）. Methods 60 IgA nephropathy patients were assigned randomly to two groups： LEF group（n= 30）, prednisolone group（n=30）. Patients of LEF group were treated LEF plus prednisolone, Patients of prednisolone were treated prednisolone. Enzyme linked immunosorbent assay （ELISA） was used to detect the urinary TGFβ1 excretion level before and after treatment. Results Before treatment and 6 months after treatment, the urinary TGFβ1 and the proteinuria in LEF group decreased significantly （P〈0.01）. Total response rate were 85.7 % in LEF group. Contracted with prednisolone group, the difference was statistically significant（P〈0.05 ）. The difference of incidence of side effects was not statistically significant（P〉0.05 ）. Conclusion Our findings may suggest that LEF plus medium or low dose prednisoloe has a better effect than that of the same dose of hormone; one of the mechanism might be the inhibition of TGFβ1.

关 键 词：肾小球肾炎 IGA/药物疗法 异恶唑类/治疗应用 糖皮质激素类/治疗应用 人类 

分 类 号：R692.310.22[医药卫生—泌尿科学]