来氟米特联合糖皮质激素治疗IgA肾病23例疗效观察

目的:研究来氟米特(LEF)联合小剂量糖皮质激素治疗IgA肾病的疗效和安全性。方法:选取37例符合条件的IgA肾病门诊及住院患者,随机分为实验组23例(来氟米特+小剂量糖皮质激素)和对照组14例(糖皮质激素)。实验组开始3d予以来氟米特50mg/d口服,3d后改为维持剂量20mg/d口服,同时予强的松20mg/d口服;对照组口服强的松0.8～1.0mg/(kg·d)。观察治疗4周后两组相关生化指标、疗效和不良反应,并进行评价。结果:治疗4周后,实验组完全缓解率8.70%,显效率为13.04%,总有效率为52.17%;对照组显效率为14.29%,总有效率为42.86%。两组治疗前后24h尿蛋白差异有显著性意义,两组间比较24h尿蛋白差异无显著性意义,两组间疗效比较差异无统计学意义。结论:来氟米特联合糖皮质激素治疗IgA肾病近期降尿蛋白疗效显著,具有较好的耐受性及安全性。

Effects of leflunomide combined with hormone therapy for lg A nephropathy

Objective ： To evaluate the effects and safety of leflunomide combined with small dose of hormone therapy for IgA nephropathy. Methods： 37patients with IgA nephropath were divided randomly into two groups： the experimental group （n= 23） and the control＇group （n= 14）. Patients of experimental group were treated with leflunomide and small dose of hormone . The initial three days , leflunomide was given to 50 mg / d, 3d later the maintenance dose to 20 mg / d . At the same time oral prednisone tablets 20 mg / d. Patients of control group were treated with prednisone 0.8-1.0 mg/（kg·d）. The clinical data were collected and evaluated before and after 4 weeks treatment. Results： In the experimental group ：the complete relieving rate was 8.7% ,significant efficient rate was 13.04 % ,the total efficient rate was 52.17%. In the control group ：the significant efficient rate was 14. 29 %,the total efficient rate was 42. 86%. The two treatment groups significantly improved proteinuria ,but caused no significant changes in serum albumin and erum creatinine. Comparison between two groups of 24h urine protein there was no significant difference in meaning between the two effects there was no significant difference. Only mild tolerable adverse effects were observed. Conclusion.. Leflunomide combined with small dose of hormone therapy can be one of the safety and effective choices for treatment of IgA nephropathy.