来氟米特与环孢素A治疗难治性肾病的疗效观察

目的观察来氟米特和环孢素治疗难治性肾病综合征的疗效差异。方法将40例难治性肾病综合征患者随机分为A、B两组,在口服泼尼松0.5mg/（kg.d）治疗的基础上,A组口服来氟米特负荷剂量60mg连服3d,减量期40mg/d连服7d,维持量20mg/d,完全缓解后减至每日最小维持量;B组口服环孢素5mg/（kg.d）。进行1年的随访,在治疗前、治疗3,6,12个月分别记录尿常规、24小时尿蛋白定量、肝功能（AST、ALT、ALb）、肾功能（CRE、UA、GLU）。并记录不良反应。结果两组患者各项指标均较治疗前好转。从治疗3个月开始,部分患者的尿蛋白定量及血浆白蛋白水平开始有所恢复,前后结果差异有统计学意义（P〈0.05）。结论来氟米特及环孢素A均可以有效地治疗难治性肾病综合征。治疗同期两者差异不明显,并且治疗过程中未出现严重的不良反应。

The Difference in the Dfficacy of Leflunomide and Dyclosporine in the Treatment of Refractory Nephrotic Syndrome

Objective To observe the difference in the efficacy of leflunomide and cyclosporine in the treatment of refractory nephrotic syndrome.Methods 40 cases of patients with refractory nephrotic syndrome were randomly divided into group A and group B.On the basic treatment with prednisone at the dose of 0.5 mg/（kg·d）,leflunomide was administered in group A at the loading dose of 60mg per day for three consecutive days,in reduction process at 40mg per day for seven consecutive days,and then at the maintenance dose of 20 mg per day,finally at a minimum maintenance dose after complete alleviation;cyclosporine was given orally at the dose of 5 mg/（kg·d）.In a one-year follow,routine urine test,24-hour urine quantitative protein,liver function（AST,ALT,ALb） and renal function（CRE,UA,GLU） were recorded respectively before treatment and 3,6 and 12 months after treatment.Side effects were also recorded.Results Each index of the two groups of patients was improved after treatment.In a part of patients,the levels of urine quantitative protein and serum albumin began to recover after 3 month of treatment,and the difference between the former and the later was of statistic significance P0.05）.Conclusion Both leflunomide and cyclosporine were effective in treating refractory nephrotic syndrome.There was no significant difference when the 2 kinds of treatment had been carried out simultaneously,and no serious side effects had been found.