来氟米特联合中等剂量泼尼松治疗IgA肾病的临床效果及安全性分析  

Clinical Effect and Safety of Leflunomide Combined with Moderate Dose Prednisone in Treatment of Patients with IgA Nephropathy

作　　者：冯玲 许晓丽 刘琼 梁维 赵静 FENG Ling;XU Xiao-li;LIU Qiong;LIANG Wei;ZHAO Jing(Department of Nephrology,the Ninth Hospital of Xi＇an,Xi＇an 710054,China)

机构地区：[1]西安市第九医院肾内科,西安710054

出　　处：《解放军医药杂志》2018年第9期97-100,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：陕西省自然科学基金项目(2013JM4012)

摘　　要：目的观察分析来氟米特联合中等剂量泼尼松治疗Ig A肾病的临床效果及安全性。方法选取2015年4月—2017年7月接受治疗的72例Ig A肾病患者进行观察研究,根据治疗方式的不同分为观察组和对照组,每组36例。对照组给予中等剂量泼尼松,观察组在对照组基础上给予来氟米特。观察比较两组的临床疗效,治疗前后相关实验室检测指标以及不良反应发生情况。结果观察组的临床总有效率明显高于对照组(P<0.01),不良反应总发生率明显低于对照组(P<0.05)。治疗后,两组的血肌酐(Scr)、24 h尿蛋白定量和尿素氮(BUN)水平明显低于治疗前,肾小球滤过率(e GFR)水平明显高于治疗前(P<0.05);观察组的Scr、24 h尿蛋白定量、BUN水平明显低于对照组,e GFR水平明显高于对照组(P<0.05)。结论来氟米特联合中等剂量泼尼松治疗Ig A肾病可以获得理想疗效,能够有效降低24 h尿蛋白定量,对改善患者预后生存质量有积极意义。Objective To observe clinical effect and safety of Leflunomide combined with moderate dose Prednisone in treatment of patients with IgA nephropathy. Methods A total of 72 patients with IgA nephropathy during April 2015 and July 2017 were divided into observation group and control group （n=36 for each group） according to different treatment methods. Control group was treated with medium dose Prednisone, while observation group was treated with Leflunomide on the basis of treatment for control group. In two groups, clinical efficacy, relevant indicators of laboratory test and incidence rate of adverse reactions before and after treatment were observed and compared. Results In observation group, the total clinical effective rate was significantly higher than that in control group （ P 〈0.01）, while the total incidence rate of adverse reactions was significantly lower than that in control group （ P 〈0.05）. After treatment, serum creatinine （Scr）, 24 h urine protein quantitation and urea nitrogen （BUN） levels were significantly lower, while glomerular filtration rate （eGFR） levels were significantly higher than those before treatment in two groups （ P 〈0.05）. In observation group, Scr, 24 h urine protein quantitation and BUN levels were significantly lower than those in control group, while eGFR level was significantly higher than that in control group （ P 〈0.05）. Conclusion Leflunomide combined with moderate dose Prednisone in treatment of patients with IgA nephropathy may achieve good therapeutic effect and effectively reduce level of 24 h urine protein quantitation, and it has positive significance for improving prognosis of patients.

关 键 词：肾小球肾炎 IGA 来氟米特 泼尼松 治疗结果 

分 类 号：R692.31[医药卫生—泌尿科学]