来氟米特联合厄贝沙坦治疗狼疮性肾炎疗效观察  

Effect of leflunomide combined with irbesartan for treating lupus nephritis

作　　者：张连云[1] 朱铁锤[1] 郭明好[2] 

机构地区：[1]新乡医学院第一附属医院肾病风湿免疫二科,河南新乡453100 [2]新乡医学院第三附属医院肾病风湿免疫科,河南新乡453003

出　　处：《新乡医学院学报》2017年第6期496-499,共4页Journal of Xinxiang Medical University

摘　　要：目的探讨来氟米特联合厄贝沙坦治疗狼疮性肾炎的临床效果。方法选取新乡医学院第一附属医院2013年3月至2016年3月收治的狼疮性肾炎患者88例,按照入院顺序分为对照组和观察组,每组44例。2组患者均采用标准激素治疗联合厄贝沙坦治疗,在此基础上,对照组患者口服环磷酰胺片3 mg·kg^(-1)·d^(-1),观察组患者口服来氟米特片,前3 d剂量为50 mg·d^(-1),3 d后减少为20 mg·d^(-1),2组患者均治疗6个月。比较2组患者治疗3、6个月后肾功能和血液学指标的变化及其疗效。结果治疗前2组患者24 h蛋白尿、尿β_2-微球蛋白(β_2-MG)、尿红细胞计数比较差异均无统计学意义(P>0.05)。2组患者治疗3、6个月时的24 h蛋白尿、尿β_2-MG、尿红细胞计数均低于治疗前(P<0.05);治疗6个月时2组患者的24 h蛋白尿、尿β_2-MG、尿红细胞计数均低于治疗3个月(P<0.05)。观察组患者治疗3、6个月时的24 h蛋白尿、尿β_2-MG、尿红细胞计数均低于对照组(P<0.05)。2组患者治疗前血白蛋白、红细胞沉降率(ESR)、血β_2-MG、血肌酐(Cr)、C反应蛋白(CRP)及补体C3水平比较差异均无统计学意义(P>0.05)。2组患者治疗3、6个月时的血白蛋白水平高于治疗前,ESR、血β_2-MG、血Cr、CRP及补体C3水平低于治疗前(P<0.05);观察组患者治疗6个月时的血白蛋白水平高于治疗3个月,ESR、血β_2-MG、血Cr、CRP及补体C3水平低于治疗3个月(P<0.05);对照组患者治疗6个月时血白蛋白、ESR及β_2-MG水平与治疗3个月时比较差异无统计学意义(P>0.05),血Cr、CRP及补体C3水平低于治疗3个月时(P<0.05)。观察组患者治疗3、6个月时血白蛋白的水平高于对照组,ESR、血β_2-MG、血Cr、CRP、补体C3水平低于对照组(P<0.05)。观察组患者治疗3、6个月时的缓解有效率分别为84.09%(37/44)、90.91%(40/44),对照组患者治疗3、6个月的缓解有效率分别为72.73%(32/44)、81.82%(36/44),观察组患者治疗3、6Objective To explore the clinical efficacy of leflunomide combined with irbesartan for treating lupus nephritis.Methods Eighty-eight patients with lupus nephritis were selected in the First Affiliated Hospital of Xinxiang Medical University from March 2013 to March 2016.The patients were divided into control group and observation group according to the admission order,with 44 patients in each group.All patients were given standard hormone therapy and irbesartan.Based on this,the patients in the control group were treated with cyclophosphamide tablet（3 mg · kg-1 · d-1）;the patients in observation group were given leflunomide tablets 50 mg · d-1 for the first 3 days,the dose reduced to 20 mg · d-1 after 3 days.All patients were treated for 6 months.The clinical efficacy,changes of renal function and hematology indexes of patients at 3,6 months after treatment were compared between the two groups.Results There was no significant difference in the 24 h proteinuria,urine β2-microglobulin（32-MG）,urine red blood cell count of patients between the two groups before treatment（P 〉 0.05）.The levels of 24 h proteinuria,urine β2-MG and urine red blood cell count of patients in the control group and observation group at 3,6 months after treatment were significantly lower than those before treatment（P 〈 0.05）;the levels of 24 h proteinuria,urine 32-MG and urine red blood cell count of patients in the two groups at 6 months after treatment were significantly lower than those at 3 months （P 〈 0.05）.The levels of 24 h proteinuria,urine β2-MG and urine red blood cell count of patients in the observation group at 3,6 months after treatment were significantly lower than those in the control group （P 〈 0.05）.There was no significant difference in the erythrocyte sedimentation rate （ESR） and the levels of albumin,β2-MG,creatinine （Cr）,C-reactive protein（CRP）,complement C3 in serum of patients between the two groups before treatment（P 〉 0.05）.The levels of blood albumin of patien

关 键 词：来氟米特 狼疮性肾炎 厄贝沙坦 

分 类 号：R593.242[医药卫生—内科学]