来氟米特联合激素治疗乙型肝炎病毒相关性肾炎的疗效

目的 观察来氟米特联合激素治疗乙型肝炎病毒相关性肾炎的临床疗效及安全性。方法 选择我科2002年10月～2005年12月间的住院患者18例，经我科肾活检病理诊断为乙型肝炎病毒相关性肾炎（早期膜性肾病或膜增殖性肾病），全部病例均口服来氟米特40mg／d，共3d，继以20mg／d维持，同时口服强的松龙30～40mg／d。观察时间6～12个月。结果 12例患者接受来氟米特治疗6～12个月，有3例完全缓解，7例部分缓解，2例无效；12个月时9例患者中又有2例完全缓解，7例仍部分缓解，最终共有5例完全缓解，7例部分缓解，0例无效。平均显效时间为用药后第6～8w，总有效率为100％。无患者出现ALT、AST升高；1例于用药4w出现轻度腹泻，而后自行缓解。合并有急性肾功能不全的患者肾功能恢复；合并有牛皮癣的1例患者皮肤症状也有所缓解。结论 来氟米特联合激素治疗乙型肝炎病毒相关性肾炎安全有效。

Leflunomide in association with the Hormone cures the HBV- GN curative effect

Objective Observe the Leflunomide unites Hormone treatment HBV - GN clinical curative effect and safeties. Methods Choose my section from October of 2002 to 2005 December the hospitalization of 18 examples sufferer, was examined a patient by my section kidney pathology for HBV - GN, all cases take orally 40 mgs/d, totally 3 ds, after maintain with the 20 rags/d, take orally the strong Leflunomide at the same time with the Methylprednisolone 30 to 40 mgs/d. Observe 6 months of time to 12 months. Results 12 sufferers accepts the Leflunomide cures 6 - 12 months, having 3 examples alleviate completely,7 parts alleviates,2 invalid; The hour of 12 months has again in 9 sufferers 2 examples alleviate completely,7 still part of alleviate, and have totally 5 examples alleviate completely,7 parts alleviates, 0 invalid. The average shows effect time as after using the medicine 6 - 8 weeks, total efficient for 100%. Having no the sufferer appears the ALT, AST goes up; 1 example in appear with 4 weeks in medicine the light degree have loose bowels, alleviating and then and by oneself. Merge not all sufferer in function in impatient kidney function instauration; Merge psoriasis 1 sufferer the skin symptom also has to alleviate. Conclusions Leflunomide unite Hormone treatment HBV- GN safety valid.