来氟米特联合强的松、对难治性原发性lgA肾病患者治疗效果的研究

目的研究来氟米特联合强的松治疗原发性IgA肾病的临床疗效。方法经肾活检确诊为原发性IgA肾病住院患者52例，将其分为对照组（24例）和观察组（28例），在基础性治疗的基础上，对照组患者给予强的松治疗，观察组给予来氟米特联合强的松治疗，6个月后进行疗效比较。结果对照组总有效率为62．5％（15／24），观察组总有效率为89．3％（25／28），观察组明显高于对照组，差异有统计学意义（x2=5．223，P〈0．05）。两组疗效经Ridit分析结果显示差异有统计学意义（Z=1．982，P〈0．05）。6个月后两组患者的24h尿蛋白、血肌酐均较治疗前有所降低，血清白蛋白升高，与治疗前比较差异有统计学意义（P〈0．05），且观察组患者的24h尿蛋白低于对照组．血清白蛋白高于对照组，差异有统计学意义（t=2．741、2．987，均P〈0．05）。对照组和观察组两组不良反应的发生率分别为25．0％（6／24）和28．6％（8／28），差异无统计学意义（P〉0．05）。结论来氟米特联合强的松治疗原发性IgA肾病安全、有效。

Study on the clinical outcome of Leflunomide combined with Prednisone in patients with refractory original IgA nephropathy

Objective To evaluate the efficacy of Leflunomide combined with Prednisone in the treatment of IgA nephropathy. Methods 52 patients with original IgA nephropathy were assigned to two groups which was control group （24 cases） and observation group （28 cases）. On the basis of basic treatment, the control group accepted Prednisone therapy, while the observation group accepted Leflunomide combined with Prednisone therapy. The effect was com- pared after treatment for 6 months. Results The total efficiency of control group was 62.5% （15/24）, while the observation group was 89.3% （25/28）, the difference was statistically significant （X2=5.223 ,P 〈 0.05）. Ridit analysis results showed that the difference in the two groups was statistically significant （Z = 1.982, P 〈 0.05）. Six months later, the two groups of patients with 24 h urinary protein, serum creatinine lower than before treatment （P 〈 0.05）. And 24 h urine protein of the observation group were lower than those in the control group, serum albumin higher than that of the control group, the differences were statistically significant （t = 2.741, 2.987, all P 〈 0.05）. The incidence of adverse reactions of control group and observation group was 25.0% （6/24） and 28.6% （8/28） respectively, with no statictically sig- nificant difference （P 〉 0.05）. Conclusion The effects of Leflunomide combined with Prednisone on original IgA nephropathy patients are efficacious and safe.