来氟米特治疗难治性肾病综合征的临床观察

目的探讨来氟米特治疗难治性肾病综合征的疗效及安全性。方法选择激素抵抗或激素依赖的肾病综合征患者23例。患者接受来氟米特(口服负荷剂量50mg/d,连续3天,之后给予维持剂量20mg/d,疗程6个月)治疗;同时口服泼尼松(30~40mg/d,共8周,以后逐渐减量至隔日20mg维持)。观察临床疗效及副作用。结果治疗1月后尿蛋白开始明显下降。治疗6个月后13例(56.5%)患者获得完全缓解,6例(26.1%)患者获得部分缓解,4例(17.4%)患者无效。治疗后血清白蛋白显著上升(P<0.01)。在治疗期间5例患者出现一过性转氨酶升高,4例患者出现白细胞减少。结论来氟米特联合泼尼松能有效地降低难治性肾病综合征患者的尿蛋白、升高血清白蛋白,且副作用较轻。

Clinical observation of Treatment of Steroid-resistant or Steroid-dependent Nephrotic Syndrome with Lefiunomide

Objective To explore the curative effects of Leflunomide on steroid-resistant or steroid-deperident nephrotic syndrome and its safety.Methods Twenty-three patients with steroid-resistant or steroid-dependent nephrotic syndrome were treated with Leflunomide(50mg/day loading dose for 3 days followed by 20mg/day orally for 6 months),and prednisone (30~40mg/day was taken for 8 weeks,and then the dosage of prednisone was tapered until a maintenance dosage of 20mg every other day).The clinical curative effects and side effects were observed.Results The urine protein was significantly decreased 1 months after the treatment .Thirteen patients(56.5%)achieved complete remission of the symptoms,six(26.1%) partial remission,and four (17.4%) were unchanged 6 months after treatment.The level of serum albumin was elevated significantly after the treatment(P<0.01).The transient elevation of glutamate-pyruvate transaminase was observed in five patients.Leukopenia occurred in four patients. Conclusion Leflunomide combined with prednisone is of good curative on effective patients with steroid-resistant or steroid-dependent nephrotic syndrome and well tolerated by the patients.