来氟米特与环磷酰胺对难治性肾病患者凝血机制的影响  

Effect of Leflunomide and Cyclophosphamide on the Clotting Mechanism in Patients with Refractory Nephropathy

作　　者：杜艳彬[1] 杨岳[1] 白亚君[1] 王宝福[1] 袁祖军 张全军[1] 

机构地区：[1]川北医学院第二临床医学院南充市中心医院,南充637000

出　　处：《血栓与止血学》2016年第2期161-164,共4页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的研究来氟米特与环磷酰胺对难治性肾病患者凝血机制的影响。方法将我院136例难治性肾病者抽签随机分为观察组与对照组,两组均为68例,对照组给予环磷酰胺静脉冲击治疗,观察组在环磷酰胺基础上采取来氟米特治疗,同时给予泼尼松常规治疗,于3月后对相关临床指标进行观察,比较两组临床疗效、凝血指标及肾功能指标改变。结果观察组总缓解率为89.71%与对照组85.29%比较无统计学意义(P>0.05);两组治疗前后PT比较无统计学意义(P>0.05),观察组治疗后a PTT为(23.26±13.14)s显著高于对照组(17.96±14.36)s,观察组治疗后D-D、Fbg分别为(0.85±0.21)mg/L、(1.88±0.62)g/L显著低于对照组(2.33±1.18)mg/L、(3.36±1.31)g/L(P<0.05);观察组TP、ALB显著高于对照组(P<0.05),ALT及AST显著低于对照组(P<0.05)。结论来氟米特联合环磷酰胺治疗难治性肾病效果显著,可缓解难治性肾病者高凝状态,改善肾功能,具有较高的安全性。Objective To study the effect of leflunomide and cyclophosphamide on the clotting mechanism in patients with refractory nephropathy. Methods 136 cases of patients with refractory nephropathy in the hospital were randomly divided into the observation group and the control group of two groups with 68 cases in each group. The control group was given cyclophosphamide intravenous pulse therapy while the observation group,based on cyclophosphamide,was given leflunomide and prednisone conventional treatment. After March,the correlated clinical indexes were observed. The clinical curative effect,changes of blood coagulation indexes and renal function were compared between the two groups. Results The total remission rate of the observation group was 89. 71%. Compared with 85. 29% of the control group,the difference was not statistically significant（ P〈0. 05）; There was nostatistical significance in the comparison of PT between the two groups before and after the treatment（ P〉0. 05）. After the treatment,a PTT in the observation group was（ 23. 26 ±13. 14） s which was significantly higher than（ 17. 96 ± 14. 36） s in the control group. D-D and Fbg were（ 0. 85± 0. 21） mg / L and（ 1. 88 ± 0. 62） g / L,respectively which were significantly lower than（ 2. 33 ± 1. 18） mg / L and（ 3. 36 ± 1. 31） g / L in the observation group（ P〈0. 05）; TP and ALT in the observation group were significantly higher than those in the control group（ P〈0. 05） while ALT and AST were significantly lower than those in the control group（ P〈0. 05）. Conclusion The effect of leflunomide combined with cyclophosphamide in the treatment of refractory nephropathy is significant,which can relieve the hypercoagulable state in patients with refractory nephropathy and improve the renal function. It is of relatively high safety.

关 键 词：来氟米特 环磷酰胺 难治性肾病 

分 类 号：R692[医药卫生—泌尿科学]