来氟米特联合糖皮质激素治疗难治性肾病综合征的疗效观察  

Observation on curative effects of leflunomide combined with glucocorticoids in the treatment of refractory nephrotic syndrome

作　　者：郭齐[1] 

机构地区：[1]山东大学附属省立医院肾内科,济南250012

出　　处：《国际医药卫生导报》2013年第18期2841-2843,共3页International Medicine and Health Guidance News

摘　　要：目的探讨来氟米特联合糖皮质激素治疗难治性肾病综合征的疗效。方法选取2009年1月至2012年1月来我院住院治疗的经肾活检病理确诊的难治性肾病综合征患者80例，随机分为观察组和对照组各40例，两组均予口服泼尼松治疗，观察组在此基础上予来氟米特治疗，比较两组疗效，观察两组患者治疗后4周、12周和24周24h尿蛋白定量、血浆白蛋白（AIJB）、血肌酐㈣及尿素氮㈣的变化隋况，同时记录治疗期间的不良反应。结果观察组治疗总有效率为80．0％，对照组为77．5％，差异无统计学意义（P〉0．05）。两组患者治疗4周后，24h尿蛋白、Scx显著降低，血浆白蛋白显著升高，差异有统计学意义（P〈0．06）；治疗12周后，两组BUN较治疗前明显降低，差异有统计学意义（P〈0．05）；治疗214周后，两组患者E述各指标与治疗后12周比较，差异有统计学意义（P〈0．05），目观察组较对照组改善更显著（P〈0．05）。结论来氟米特联合激素治疗难治性肾病综合征安全有效、不良反应少，其长期疗效、远期预后及不良反应毋需深入研究。Objective To investigate the efficacy of leflunomide combined with glucocortieoids in the treatment of refractory nephrotic syndrome. Methods In our hospital from January 2009 to January 2012, we selected 80 patients with renal biopsy diagnosis of refractory nephrotic syndrome as research subjects, according to different treatment they were divided into observation group and control group, 40 cases in each group, and two groups were treated with oral prednisone, the observation group on the basis of the prednisone treatment was given leflunomide treatment, the efficacy was compared between two groups, and then observed 24 h urinary protein, serum albumin （ALB）, serum creatinine （Scr） and blood urea nitrogen （BUN） changes after treatment of 4 weeks, 12 weeks and 24 weeks, and recorded adverse reactions during treatment. Results The patients of two groups after treatment of 24 weeks, efficacy evaluation showed that the rate of complete remission of the observation group and control group a significant response rate, partial response rate and the total effective rate were compared between the two groups with no statistical significant difference （P〉0.05）. After treatment for 4 weeks, compared with those before treatment, 24 h urinary protein, Scr were significantly lower, serum albumin was significantly higher, the difference was statistically significant （P〈0.05）; BUN of the observation group and control group patients decreased significantly after treatment for 12 weeks, respectively, the difference was significant （P〈0.05）; after treatment for 24 weeks, the above indicators, compared with those after treatment of 12 weeks, showed the significant difference （P〈0.05）, and observation group improved more significantly than control group （P〈0.05）. Conclusion Leflunomide combined hormone treatment of refractory nephrotic syndrome is safe and effective, with less adverse reaction, which is worthy of wider promotion and appficafion, but the study did not extend the comse of clin

关 键 词：难治性肾病综合征 来氟米特 糖皮质激素 

分 类 号：R692.3[医药卫生—泌尿科学]