来氟米特治疗表现为难治性肾病综合征的IgA肾病临床分析

目的：观察来氟米特治疗表现为难治性肾病综合征的IgA患者的疗效。方法：经常规治疗无效的此类IgA肾病患者38例,予以来氟米特治疗,观察治疗前、治疗后4周、8周、12周及6个月的24h尿蛋白定量、肝功能、肾功能、血脂、免疫球蛋白等相关临床指标以及用药期间所有不良反应。结果：治疗后尿蛋白定量明显减少,血清白蛋白升高,与治疗前相比,差异均有统计学意义（P〈0.05）。治疗6个月时完全缓解9例,占23.7%;显效11例,占28.95%;有效7例,占18.4%;总有效率71.1%;无效11例,占28.95%。不良反应轻微,患者耐受性良好。结论：来氟米特是治疗表现为难治性肾病综合征的IgA患者的一种安全有效药物。

Clinical Analysis of Leflunomide on IgA Nephropathy Presented as Refractory Nephrotic Syndrome

Objective：To observe the curative effect of leflunomide in treatment of IgA nephopathy presented as refractory nephrotic syndrome.Methods：Thirty-eight patients with IgA nephopathy （refractory nephrotic syndrome type） who were not responsive to standard regimen of prednisone and cyclophosphamide were treated by leflunomide and prednisone.Clinical data were collected and evaluated in the 4th,8th,12th,and 24th weeks.Adverse reaction was investigated in the treatment.Results：After receiving leflunomide therapy for 6 months,the proteinuria in these patients decreased significantly（P0.05）,and serum albumin increased significantly（P0.05）.Nine cases were found complete remission,eleven cases obvious effect,seven cases part remission,eleven cases no resonse. The total effective rate was 71.1%.The side effects were mild,and all patients tolerated this therapy.Conclusion：It was effective and safe of leflunomide to treat IgA nephopathy presented as refractory nephrotic syndrome.