来氟米特与泼尼松对免疫球蛋白A肾病的临床疗效与安全性研究  

Clinical efficacy and safety for leflunomide and dehydrocortisone in the treatment of immunoglobulin A nephropathy

作　　者：沈世忠[1] 杨忠民[1] 蔡佳盈[1] 谢潜红[1] 胡义阳[1] 孙凌云[1] 姜宗培[2] 

机构地区：[1]福建医科大学附属泉州第一医院肾内科,福建泉州362000 [2]中山大学附属第六医院肾内科,广州510655

出　　处：《中国临床药理学杂志》2016年第1期6-8,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察来氟米特与糖皮质激素治疗免疫球蛋白A(IgA)肾病的临床疗效及安全性。方法 60例IgA肾病患者分为试验组28例,对照组32例。对照组口服泼尼松0.5 mg·kg-1,2个月后每2周减少5 mg;试验组口服来氟米特20mg,每日2次,3 d后改为20 mg,每日1次。2组患者治疗周期均为3个月。比较2组患者治疗前后的24 h尿蛋白、肾小球滤过率及血清白蛋白变化及临床疗效。结果对照组与试验组的临床总有效率分别为53.13%和64.29%,差异无统计学意义(P>0.05);与治疗前相比,2组患者治疗后24 h尿蛋白明显降低,而肾小球滤过率及白蛋白明显升高(P<0.05);但治疗后上述指标组间比较差异无统计学意义(P<0.05);试验组与对照组不良反应发生率分别为21.43%和15.63%,差异无统计学意义(P>0.05)。结论来氟米特治疗IgA肾病安全有效,与糖皮质无明显差异。Objective To evaluate the clinical efficacy and safety between leflunomide and dehydrocortisone in the treatment of immunoglobulin A（ IgA） nephropathy. Methods Sixty IgA nephropathy patients were divided into control group（ n = 32） and experiment group（ n = 28）.Patients in control group were administered metacortandracin 0. 5mg·kg-1until 2 months. And then with 5 mg decrease every 2 weeks.Patients in experiment group were administered leflunomide 20 mg,twice a day for 3 days and than 20 mg,once a day for 3 months. The 24 h urine protein,glomerular filtration rate,albumin,clinical efficacy and safety were compared between the two groups. Results After treatment,the effective rate were 53. 13% and 64. 29% in control and experiment group,with no statistical difference（ P〉0. 05）. The 24 h urine protein was significantly decreased（ P〈0. 05）,glomerular filtration rate and albumin significantly increased in two groups after treatment（ P〉0. 05）,but there was no statistical difference between the two group（ P〈0. 05）.The incidence rate of adverse drug reaction in experiment group and control group were 21. 43% and 15. 63%,without significant difference（ P〉0. 05）. Conclusion Leflunomide was effective and safe in the treatment of IgA nephropathy,without difference with dehydrocortisone.

关 键 词：免疫球蛋白A肾病 来氟米特 糖皮质激素 蛋白尿 

分 类 号：R692[医药卫生—泌尿科学] R979.5[医药卫生—外科学]