来氟米特联合激素治疗难治性肾病综合征疗效观察

目的观察来氟米特联合激素治疗难治性肾病综合征的临床疗效及安全性。方法将186例难治性肾病综合征患者分为观察组(90例)和对照组(96例),对照组患者给予环磷酰胺联合泼尼松治疗,观察组患者给予来氟米特联合泼尼松治疗,疗程均为48周。对比观察2组治疗前及治疗4、8、12、24、48周的疗效、血常规、肝肾功能、24 h尿蛋白定量及不良反应。结果治疗前2组患者24 h尿蛋白定量、血肌酐和血清白蛋白水平比较差异无统计学意义(P>0.05);与治疗前比较,2组治疗后24 h尿蛋白定量和血肌酐逐渐下降(P<0.05),而血清白蛋白水平逐渐升高(P<0.05)。治疗第8、12、24、48周,观察组患者24 h尿蛋白定量和血肌酐水平低于对照组(P<0.05),而血清白蛋白水平高于对照组(P<0.05)。观察组总有效率显著高于对照组(P<0.05),不良反应发生率显著低于对照组(P<0.01)。结论来氟米特联合激素治疗难治性肾病综合征疗效满意,且不良反应少。

Effect of leflunomide combined with hormone on patients with refractory nephrotic syndrome

Objective To study the clinical effect and safety of leflunomide combined with hormone on patients with refractory nephrotic syndrome. Methods One hundred and eighty-six patients with refractory nephrotic syndrome were divided into two groups.Ninety-six patients in control group were treated with cyclophosphamide and prednisone,ninety patients in observation group were treated with leflunomide and prednisone,the course of treatment was forty-eight weeks.Clinic effects,liver function,renal function,24 hours urine protein quantitation and adverse effects were detected and compared before and after treatment for 4,8,12,24 and 48 weeks. Results Before treatment,there was no statistical difference in 24 hours urine protein quantitation,the levels of serum creatinine and seralbumin between two groups(P>0.05).Compared with pretreatment,the 24 hours urine protein quantitation and serum creatinine decreased gradually(P<0.05),but seralbumin level increased gradually in two groups(P<0.05).After 8,12,24 and 48 weeks of treatment,24 hours urine protein quantitation and serum creatinine level in observation group were lower than these in control group(P<0.05),but serum albumin level in observation group was higher than that in control group(P<0.05).Compared with control group,the total effective rate was significantly higher(P<0.05),but the adverse effect incidence was significantly lower in observation group(P<0.01). Conclusion Leflunomide combined with hormone on patients with refractory nephrotic syndrome can obtain exhibit satisfactory effect and mild adverse effect.