来氟米特联合环磷酰胺冲击治疗重症顽固性狼疮肾的疗效分析

目的 探讨来氟米特联合环磷酰胺冲击治疗对重症顽固性狼疮肾患者的疗效.方法 收集本院2013年1月至2014年11月入院的88例重症顽固性狼疮肾患者随机分为两组.对照组患者给予环磷酰胺治疗,实验组患者加来氟米特治疗,比较两组患者病情总体缓解情况、治疗前后生化指标与SLEDAI评分、免疫指标等.结果 实验组患者总体缓解率(90.91％)显著优于对照组(72.73％),两组比较差异具有统计学意义(P＜0.01);实验组患者治疗后尿蛋白(0.45±0.27) g/24 h]、BUN(6.47±1.23) mmol/L]、Cr(78.31 ±7.75)μmol/L]与SLEDAI评分(3.06±0.54)显著低于对照组,Hb(106.01±10.86) g/L]与ALB(38.95±3.86) g/L]显著高于对照组,两组比较差异具有统计学意义(P＜0.01);实验组患者治疗后抗dsDNA阳性、ANA滴度与IgG水平组间比较显著低于对照组,C3、C4水平高于对照组,差异具有统计学意义(P＜ 0.01).结论 来氟米特联合环磷酰胺冲击治疗对重症顽固性狼疮肾患者的疗效显著,具有借鉴性.

Efficacy of leflunomide combined with cyclophosphamide pulse therapy for severe refractory lupus nephritis

Objective To investigate the efficacy of leflunomide combined with cyclophosphamide pulse therapy for severe refractory lupus nephritis.Methods 88 cases of severe refractory lupus nephritis admitted in our hospital from January 2013 to November 2014 were randomly divided into two groups.Control group was treated with cyclophosphamide,and experimental group was treated with leflunomide on the basis of control group.Compared overall relief of patients' condition,biochemical indices,SLEDAI score,and immune indicators before and after treatment.Results The overall relief rate of experimental group was significantly higher than that of control group (90.91％ vs.72.73％),with statistically significant difference between two groups (P＜0.01).Urinary protein (0.45±0.27) g/24 h],BUN (6.47±1.23) mmol/L],Cr (78.31±7.75)μmol/L] and SLEDAI score (3.06±0.54)] of experimental group after treatment were significantly lower than those of control group,Hb (106.01±10.86) g/L] and ALB (38.95±3.86) g/L] were significantly higher than those of control group,with statistically significant differences between two groups (P＜0.01).Anti-dsDNA positive,ANA titer,and IgG level of experimental group after treatment were significant lower than those of control group,C3 and C4 levels were significantly higher than those of control group,with statistically significant differences between two groups (P＜0.01).Conclusion The efficacy of leflunomide combined with cyclophosphamide pulse therapy for severe refractory lupus nephritis patients is significant,with reference.