来氟米特与环孢素A治疗原发性难治性肾病综合征的效果比较  

Comparison of effect of leflunomide and cyclosporine A in the treatment of primary refractory nephrotic syndrome

作　　者：刘飞燕 Liu Feiyan(Department of Nephrotic Rheumatism,General Hospital of Pingmei Shenma Medical Group,Pingdingshan 467000,China)

机构地区：[1]平煤神马医疗集团总医院肾病风湿科,平顶山467000

出　　处：《中国实用医刊》2023年第18期84-87,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨来氟米特与环孢素A治疗原发性难治性肾病综合征(RNS)的效果。方法抽取2019年5月至2020年9月平煤神马医疗集团总医院收治的原发性RNS患者72例,按照随机数字表法分为对照组与研究组,每组36例。对照组采用环孢素A治疗,研究组采用来氟米特治疗。比较两组治疗效果,比较两组治疗前后肾功能[24 h尿蛋白定量、血尿氮素(BUN)、血肌酐(Scr)]、肝功能[天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)]、血脂[三酰甘油(TG)、总胆固醇(TC)]水平,比较两组不良反应发生率。结果研究组总有效率(91.67%,33/36)与对照组(80.56%,29/36)比较差异未见统计学意义(P>0.05)。治疗后24 h,两组尿蛋白定量、BUN、Scr水平均低于治疗前,且研究组24 h尿蛋白定量低于对照组(P<0.05)。治疗后,两组AST、ALT水平均高于治疗前(P均<0.05),但治疗后两组间比较差异未见统计学意义(P>0.05)。研究组不良反应发生率(2.78%,1/36)低于对照组(22.22%,8/36),P<0.05。结论来氟米特与环孢素A治疗原发性RNS的效果相当,但与环孢素A相比,来氟米特能快速降低24 h尿蛋白定量,并可减少不良反应的发生。Objective To study the efficacy of leflunomide and cyclosporine A in the treatment of primary refractory nephrotic syndrome(RNS).Methods A total of 72 patients with primary RNS treated in General Hospital of Pingmei Shenma Medical Group from May 2019 to September 2020 were selected,and they were divided into control group and study group according to the random number table method,with 36 cases in each group.The control group was treated with cyclosporine A,and the study group was treated with leflunomide.The efficacy of the two groups were compared.The renal function assessed by 24-hour urinary protein quantity,blood urea nitrogen(BUN)and serum creatinine(Scr),liver function assessed by aspartate transaminase(AST)and alanine transaminase(ALT),blood lipid level assessed by triacylglycerol(TG)and total cholesterol(TC)were compared between the two groups before and after treatment.The incidence of adverse reactions were compared between the two groups.Results There was no significant difference in the total effective rate between the study group(91.67%,33/36)and the control group(80.56%,29/36),P>0.05.Twenty-four hours after treatment,the levels of 24-hour urinary protein quantity,BUN and Scr in the two groups were lower than those before treatment,and 24-hour urinary protein quantity level in the study group was lower than that in the control group(P<0.05).After treatment,the levels of AST and ALT in the two groups were lower than those before treatment(all P<0.05).However,there were no significant differences in levels of AST and ALT between the two groups after treatment(P>0.05).The incidence of adverse reactions in the study group(2.78%,1/36)was lower than that in the control group(22.22%,8/36),P<0.05.Conclusions Leflunomide has the comparable efficacy to cyclosporine A in the treatment of primary RNS.However,leflunomide,compared with cyclosporine A,can rapidly reduce the 24-hour urinary protein quantity and reduce incidence of adverse reactions.

关 键 词：肾病综合征 难治性 环孢素A 来氟米特 肾功能 

分 类 号：R692[医药卫生—泌尿科学]